Dosage and Administration
Local prescribing information should be consulted for detailed
information, including contraindications, dosages, drug interactions,
precautions and use in special patient populations.
Dosage changes may be necessary in older patients or those with hepatic
impairment when using Dexmeditomidine in the United States. Children and
adolescents under the age of 18 should avoid using Dexmeditomidine due
to the lack of data on its pharmacokinetics, effectiveness, and
tolerance. After 24 hours, Dexmeditomidine is not recommended; instead,
the rate of the maintenance infusion should be modified to obtain the
desired sedation level. Prior to extubation, Dexmeditomidine sedation
should not be terminated in mechanically ventilated patients.
Patient care should be closely monitored while they are receiving
Dexmeditomidine. Only an expert in patient care in an operating room or
intensive care unit should administer this medication.
Dexmeditomidine should not be infused through an intravenous catheter
used to draw blood or plasma until a physical compatibility has been
established. Due to potential pharmacodynamics interactions,
Dexmeditomidine may need to be reduced when provided with amphotericin B
and diazepam; this is because Dexmeditomidine has been demonstrated to
be incompatible with these medications.
Bradycardia, hypotension, sinus arrest, and transitory hypertension have
been linked to the use of Dexmeditomidine.
Dexmedetomidine’s early peripheral vasoconstrictive effects caused
temporary hypertension largely during the loading dose infusion;
however, it is not always necessary to address this condition.
In patients with extensive heart block and/or significant ventricular
dysfunction, Dexmeditomidine should be used with caution.
Dexmeditomidine with other vasodilators or negative chronoscopic drugs
should be used with caution, even though an additive pharmacodynamics
impact has not been reported.
In the ICU and for surgical sedation, the Use of Dexmeditomidine in
Mechanically Ventilated Patients
In order to provide the best possible sedation for a given patient and
procedure, the optimum amount of sedation must take the patient’s acute
illness, as well as any therapeutic or supportive measures, into
consideration. When aiming to optimize sedation, consideration should be
given to the specific properties of the agent, including
pharmacokinetics, potential adverse events (in vulnerable individuals),
and the use of sedation-reducing measures.