Thursday March 1, 2007
Regarding Dexmedetomidine (Precedex)

One sedative which has been successfully used in cardiothoracic ICUs but didn't made real penetration in medical ICUs is Dexmedetomidine (Precedex).

The unique property of precedex of no respiratory depression helps in extubating agitated patients and can be continued beyond extubation (which is in contrast to other sedatives) . Another advantage of Precedex is its analgesic property. It minimize the simultaneous use of other analgesics. It possesses anxiolytic, anesthetic, hypnotic, and analgesic properties.

The dose is IV bolus of 1 mcg/kg over a 10-minute period, followed by a continuous IV infusion of 0.2 mcg/kg per hour which can be titarted upto 0.7 mcg/kg. Due to lack of data on this drug some hospitals restrict its use for 24 to 48 hours.

This drug should be avoided with bradycadia and heart blocks. Interestingly, continuous infusion cause hypotension as like propofol but hypertension can occur with loading dose !!

See nice review article: The Role of Dexmedetomidine (Precedex) in the Sedation of Critically Ill Patients (ref: P&T, Vol. 30 No. 3 • March 2005 , 158-161)