Dexmedetomidine Properties

Basic, Generic Clinical Sciences

  • MOA: central alpha-2 adrenergic agonist, acts on receptors in the brain (locus ceruleus) and spinal cord

  • In the same class as clonidine but dexmedetomidine is more selective for alpha 2 receptors

  • Onset: IV loading dose 5-10 minutes

  • Peak Effect: IV loading dose 15-30 minutes

  • Duration: 60-120 minutes

  • Half-life: 2-3 hours

  • Dosing: loading dose of 1 mcg/kg over 10 minutes followed by an infusion at a rate of 0.2 - 0.7 mcg/kg/hr

  • Metabolism: metabolized in the liver, metabolites eliminated in the urine

  • Dosage reductions should be used in patients with liver or kidney disease

  • Effects: acts as a sedative, analgesic, and sympatholytic agent

  • Clinical Uses: dose dependent sedation, anxiolysis, blunting of sympathetic response to surgery, opioid-sparing agent, adjunct agent to general anesthesia, MAC sedation

  • Benefits: does not significantly depress ventilation

  • Adverse effects: bradycardia, heart block, hypotension, discontinuation after prolonged use can result in withdrawal phenomenon


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Kelsey Savery, MD