Dexmedetomidine

Used for:

• Short surgeries or procedures (e.g., colonoscopy) in non-intubated patients

• Mechanically ventilated and intubated patients in the ICU

Mechanism:

• Alpha-2 agonist: Activates alpha-2 adrenergic receptors which inhibits central release of norepinephrine and blocks sympathetic activity

CNS Effects:

• Decreases cerebral oxygen consumption and blood flow: Due to reduced brain activity/metabolic rate. Some research to suggest that dexmedetomidine does not affect intracranial pressure. 

Cardiovascular (CV) Effects: 

• Causes a brief hypertensive phase, followed by hypotensive phase

• Decreases HR

Respiratory Effects:

• Stable RR: Does not cause respiratory depression

Adverse Effects:

• Use cautiously in patients with hypotension and bradycardia

Absolute Contraindications:

• None