Alpha2-Adrenergic Agonist; Sedative

CCP: Sedation of mechanically ventilated patient

CCP: Procedural sedation

• Hypersensitivity
• Avoid abrupt withdrawal

Cautions

• Elderly patients
• Hepatic impairment
• 2^nd or 3^rd degree AV block
• Severe ventricular dysfunction
• Sick sinus syndrome
• Hypotension
• Hypovolemia
• Diabetes mellitus

Onset: 5-10 minutes

Peak effect: 15-30 minutes

Duration: 60-120 minutes

Half-life: 2 hours

Cardiovascular

• Hypotension, bradycardia, systolic hypertension, tachycardia, hypertension, hypertension
• Atrial fibrillation, peripheral edema, hypovolemia, edema

Central nervous system

• Agitation
• Anxiety

Gastrointestinal

• Constipation, nausea
• Xerostomia

Respiratory

• Respiratory depression
• Respiratory failure, adult respiratory distress syndrome, pleural effusion, wheezing

Endocrine & metabolic

• Hypokalemia, hyperglycemia, hypoglycemia, increased thirst, hypocalcemia, hypomagnesemia

Genitourinary

• Oliguria

Hematologic & oncologic

• Anemia

Renal

• Acute renal failure, decreased urine output

Miscellaneous:

• Fever, withdrawal syndrome 

• Episodes of bradycardia, hypotension, and sinus arrest have been associated with rapid IV administration (eg, loading administration) or when given to patients with high vagal tone.
• Transient paradoxical hypertension has been primarily observed during loading dose administration and high peak plasma concentrations.
• Use with caution in patients with heart block, bradycardia, severe ventricular dysfunction, hypovolemia, or chronic hypertension.
• Use of infusions > 24 hours has been associated with tolerance and tachyphylaxis and dose-related increase in adverse reactions.
• Patients may be arousable and alert when stimulated. This alone should not be considered as lack of efficacy in the absence of other clinical signs/symptoms.
• Use for > 24 hours is not recommended by the manufacturer.
• Dexmedetomidine is expected to cross the placenta. Information related to use during pregnancy is limited.
• It is not known if dexmedetomidine is excreted in breast milk. According to the manufacturer, the decision to continue or discontinue breastfeeding during therapy should take into account the risk of infant exposure, the benefits of breastfeeding to the infant, and benefits of treatment to the mother.

• Alfuzosin
• Amifostine
• Amisulpride (Oral
• Antipsychotic Agents
• Barbiturates
• Benperidol
• Blood Pressure Lowering Agents
• Bradycardia-Causing Agents
• Brimonidine (Topical
• Bromperidol
• Ceritinib
• Diazoxide
• DULoxetine
• Fexinidazole
• Fingolimod
• Herbal Products with Blood Pressure Lowering Effects
• Hypotension-Associated Agents
• Ivabradine
• Lacosamide
• Levodopa-Containing Products
• Lormetazepam
• Midodrine
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• Tricyclic Antidepressants