Clinical indications: analgesic. Most effective via epidural
route. Oral or transdermal use as adjunct for
sedation/analgesia in critically ill
Dosing: 5mcg/kg/day; transdermal patches - 100 - 300mcg
Onset & elimination: 1-3 hours. Half life 1 2 - 24 hours.
Precautions: May develop rebound hypertension with abrupt
discontinuation. Can stop without weaning if given for 3- 4
days. If weaning transdermal patch, titrate off over 2-3 weeks
- Dexmedetomidine [13,15,17]^
Clinical indications: sedative and analgesic for mechanically
ventilated patients in an intensive care settings and non
intubated adult patients prior to or during surgical or other
procedures. Only FDA approved for adult use, but is used
widely in children.
Safety in children described in literature with low rate of
adverse effects, which include hypotension, bradycardia, and
hypertension. Majority of adverse events resolved without
treatment or by decreasing dose of infusion The incidence of
adverse effects did not increase with increased duration of
therapy.^16
Clinical effects: Highly lipid soluble – crosses the blood brain
barrier quickly.
