MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

 

Generic Name:

Dexmedetomidine

Brand Name:

Precedex®

Action:

a -2 Adrenoceptor agonist

Indications:

Dexmedetomidine is approved to control agitation during the peri-extubation period.

Restrictions:

To be considered for dexmedetomidine, all patients must be evaluated by a pharmacist.  Please page unit pharmacist for evaluation. (see pharmacist evaluation tool)

Usual Dosage Range and Route:

Loading Dose: 1mcg/kg over 10 min ** Maintenance Infusion: then 0.2-0.7 mcg/kg/hr

Standard Concentration:

Microinfusion Syringe: 200mcg/50ml NS Syringe Mixing Guidelines: Dilute with 0.9% sodium chloride only

Administration Guidelines:

Loading dose is not necessary for all patients.   ** Loading dose may cause hyper tension, increase loading dose infusion time to 20 minutes.   Titrate to control agitation during the peri-extubation period.

Special Considerations:

  • Refer to pharmacist evaluation tool for inclusion/exclusion criteria and additional considerations. 

  • 94% protein bound to albumin and µ 1-glycoprotien

  • May need to reduce in hepatic failure

Precautions and Side Effects:

  • Significant hypotension ·         
  • Nausea
  • Significant bradycardia
  • Atrial fibrillation
  • Hypoxia
  • Acute heart failure