Dexmedetomidine hydrochloride

An alpha-2 adrenergic agonist used in anesthesia and intensive care.

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Dexmedetomidine hydrochloride

Drug Information
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Dexmedetomidine hydrochloride is a medication primarily used for its sedative and analgesic properties. It is an alpha-2 adrenergic agonist that is commonly used in anesthesia and intensive care medicine.

Pharmacology

Dexmedetomidine acts on the alpha-2 adrenergic receptors in the central nervous system, leading to sedation, anxiolysis, and analgesia. It has a high selectivity for these receptors, which results in fewer side effects compared to other sedatives. The drug is known for its ability to provide sedation without causing significant respiratory depression, making it a valuable option in various clinical settings.

Clinical Uses

Dexmedetomidine is used in several clinical scenarios:

• Sedation in Intensive Care Units (ICUs):It is used for sedation of intubated and mechanically ventilated patients in the ICU.
• Procedural Sedation:It is used for sedation during various medical procedures, including colonoscopy and bronchoscopy.
• Adjunct in Anesthesia:It is used as an adjunct to general anesthesia to provide sedation and analgesia.

Side Effects

Common side effects of dexmedetomidine include:

• Hypotension
• Bradycardia
• Dry mouth
• Nausea

Contraindications

Dexmedetomidine should be used with caution in patients with severe heart block, advanced heart failure, or severe liver impairment.

Mechanism of Action

Dexmedetomidine works by binding to alpha-2 adrenergic receptors in the brain and spinal cord. This binding inhibits the release of norepinephrine, leading to decreased sympathetic activity and resulting in sedation and analgesia.

Pharmacokinetics

Dexmedetomidine is metabolized in the liver, primarily by the enzyme CYP2A6. It has a relatively short elimination half-life of approximately 2 hours, and its metabolites are excreted mainly in the urine.

History

Dexmedetomidine was developed in the 1990s and was approved for medical use in the United States in 1999. It has since become a widely used sedative in various medical settings.

Also see

• Alpha-2 adrenergic agonist
• Sedation
• Anesthesia
• Intensive care medicine

Sedatives and Hypnotics

• Antihistamines
• Diphenhydramine
• Doxylamine
• Hydroxyzine

• Barbiturates
  • Amobarbital
  • Butabarbital
  • Phenobarbital
  • Secobarbital

• Benzodiazepines
  • Diazepam
  • Estazolam
  • Flurazepam
  • Quazepam
  • Temazepam
  • Triazolam

• Benzodiazepine Receptor Agonists
  • Eszopiclone
  • Zaleplon
  • Zolpidem

• Herbals
  • Chamomile (Matricaria recutita)
  • Hops (Humulus lupulus)
  • Lavender (Lavandula angustifolia)
  • Passionflower (Passiflora incarnata)
  • Valerian (Valeriana officinalis)

• Melatonin and its Analogues
  • Melatonin
  • Ramelteon
  • Tasimelteon

Miscellaneous Agents

• • Buspirone
  • Chloral hydrate
  • Doxepin
  • Meprobamate
  • Sodium Oxybate (Narcolepsy Agent)
  • Suvorexant