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notesdexmed

Dexmedetomidine


Dexmedetomidine

• Pure alpha 2 agonist (alpha 2 receptors found in CNS, platelets, liver, kidney, eye)
• Causes sedation, anxiolysis, sympatholytic blockage, analgesia
• Modulates release of norepinephrine (NE) and adenosine triphosphate (ATP)
• In CNS, causes decreased blood pressure, decreased heart rate, sedation, analgesia
• In periphery, causes decreased salivation, decreased secretions, decreased gastric motility, decreased insulin release
• Sedation occurs in locus coeruleus in brainstorm (locus coeruleus modulates wakefulness)
• Analgesic effects come from dorsal horn of spinal cord
• Cardiovascular effects include decreased sympathetic outflow of autonomic nervous system
• Don’t give a bolus; it can cause a profound drop in blood pressure
• Protein binding is 94%
• Metabolized in the liver
• Causes post-operative bradycardia in 40% of patients
• Minimal respiratory depression
• Patients are easily arousable, but can lapse back into sedation
• Run at 0.2 to 0.7 mcg/kg/hour


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