Other Brands/Names

Icunes, Kabimidine, Neodex, Precedex.

How it Works

Dexmedetomidine is a sedative that acts on the central nervous system by reducing brain activity. It also produces anesthetic effects by stimulating certain proteins at receptors in the brainstem, which suppress the release of norepinephrine. Norepinephrine is a hormone involved in alertness and concentration, so lowering its activity results in sedation and relaxation.

Indications

This medication is commonly used in intensive care settings to provide sedation or reduce consciousness in patients who need to be placed on a ventilator to support breathing. It helps relax patients during both ventilation and intubation.

In addition, dexmedetomidine is used during anesthesia to prepare patients for surgery or other medical procedures.

Contraindications

Dexmedetomidine should not be used in patients with the following conditions:

• Allergy to dexmedetomidine

• History of uncontrolled low blood pressure (hypotension)

• Heart rhythm disorders, particularly second or third-degree AV block

• Acute cerebrovascular disorders, such as:

  • Stroke

  • Narrowing of blood vessels in the brain

  • Reduced space between the spinal cord and an aneurysm

  • Aneurysm (abnormal blood vessel widening that may rupture)

Side Effects

Within the first 48 hours after discontinuing dexmedetomidine, patients may experience side effects such as:

• Headache, confusion, anxiety, or restlessness

• Stomach pain, diarrhea, or constipation

• Weakness or fatigue

• Excessive sweating

• Weight loss

• Blurred vision

• Chest pain or irregular heartbeat

Types

This medication is available as a 100 mcg/mL injectable vial solution.

Dosage

Dexmedetomidine is administered by injection to adult patients. Since it is often prepared as a powder, it is typically diluted to a concentration of 4 mcg/mL in one of the following before use: 5% glucose infusion solution, lactated Ringer’s solution, mannitol, or 0.9% sodium chloride solution.

Safety

Dexmedetomidine must be given only by trained healthcare professionals in an intensive care unit, under close monitoring. Patients should inform their doctor of their medical history, including whether they are pregnant, breastfeeding, or if they have heart or liver disorders. Currently, there are no safety studies on its use during pregnancy or its effects on unborn babies. For breastfeeding mothers, it is advised not to breastfeed within 10 hours after receiving dexmedetomidine.

Drug Interactions

Dexmedetomidine may interact with other medications and cause dangerous drowsiness or slowed breathing, which can sometimes be life-threatening. Patients must inform their doctor about all medicines they are taking before starting this drug.

When combined with anesthetics, other sedatives, hypnotics, or opioids, dexmedetomidine may enhance sedative effects. It should also not be used together with the antifungal amphotericin B or the anticonvulsant diazepam.

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