- 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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