#建議持續輸注 (IV pump) 之高警訊藥品

鎮靜
Mechanically ventilated patients in the ICU, sedation: Sedation of intubated, mechanically ventilated patients in the ICU (during extubation and post extubation)
Procedural sedation or monitored anesthesia care: Procedural sedation prior to and/or during awake fiberoptic intubation, surgical, or other procedures

Alpha2-Adrenergic Agonist
Selective alpha2-adrenoceptor agonist with anesthetic and sedative properties thought to be due to activation of G-proteins by alpha2a-adrenoceptors in the brainstem resulting in inhibition of norepinephrine release; peripheral alpha2b-adrenoceptors are activated at high doses or with rapid IV administration resulting in vasoconstriction.

1. Onset of action: (IV loading dose) 5 to 10 minutes
2. Peak effect: (IV loading dose) 15 to 30 minutes; (IV continuous infusion) 60 minutes
3. Duration (dose dependent): 60 to 240 minutes
4. Vss: (Neonates) 2.7 L/kg to 3.9 L/kg; (<2 years) 3.8 L/kg; (2 to 11 years) 2.2 L/kg; (Adults) ~118 L
5. Protein binding: ~94%
6. Metabolism: Hepatic via N-glucuronidation, N-methylation, and CYP2A6
7. Half-life elimination: (Neonates) 3.2 to 7.6 hours; (<2 years) 2.3 hours; (2 to 11 years) 1.6 hours; (Adults) ~up to 3 hours
8. Excretion: Urine (95%); feces (4%)

Hypersensitivity to dexmedetomidine

C

Excretion in breast milk unknown/use caution

Hypotension, bradycardia, nausea, xerostomia, hypertension, tachycardia, pyrexia

ICU sedation:
1. Initial: Loading infusion of 1 mcg/kg over 10 minutes
2. Followed by a continuous infusion: 0.2 to 1.5 mcg/kg/hour; titrate by 0.2 mcg/kg/hour every 30 minutes to sedation goal or clinical effect
Procedural sedation or monitored anesthesia care:
1. Initial: Loading dose of 0.5 to 1 mcg/kg over 10 minutes
2. Followed by a continuous infusion: 0.2 to 1 mcg/kg/hour; titrate to desired level of sedation

There are no dosage adjustments provided in the manufacturer's labeling; however, pharmacokinetics were not significantly different in patients with severe renal impairment (CrCl <30 mL/minute).

There are no specific dosage adjustments provided in the manufacturer's labeling; however, consider a dose reduction.