DEXMEDETOMIDINE
(Precedex)Standard Prescription
dexmedetomidine __mcg IV x 1 loading dose (__mcg/kg/dose)
dexmedetomidine__mcg/kg/hr continuous IV infusion
dexmedetomidine __mcg INTRANASAL x 1 dose (__mcg/kg/dose). Give half of the total dose into each nostril.
Dosages
Sedation for Mechanical ventilation:
Loading dose: 0.2-0.6 mcg/kg/dose IV over 10-20 minutes
Continuous IV infusion: Initial: 0.2 mcg/kg/hr; titrate to 0.1 - 0.7 mcg/kg/hr
Usual max: 1 mcg/kg/hr
Burn patients:
Loading dose: 0.2-0.6 mcg/kg/dose IV over 10-20 min.
Continuous IV infusion: Initial: 0.2 mcg/kg/hr; titrate to 0.1- 2 mcg/kg/hr. **Note higher dosage range in burn patients.
Adjunct to Analgesia:
Continuous IV infusion:
Intranasal:
1-3 mcg/kg/dose intranasal 20-45 minutes prior to procedure. Give half of the total dose into each nostril. Maximum 200 mcg/dose (100 mcg per nostril). If repeat dose is necessary maximum 1 mcg/kg/dose.
Check Nursing Guideline on PHSA SHOP: Intranasal Drug Delivery via Atomizer
Loading dose: 0.2-0.6 mcg/kg/dose IV over 10-20 minutes
Continuous IV infusion: Initial: 0.2 mcg/kg/hr; titrate to 0.1 - 0.7 mcg/kg/hr
Usual max: 1 mcg/kg/hr
Burn patients:
Loading dose: 0.2-0.6 mcg/kg/dose IV over 10-20 min.
Continuous IV infusion: Initial: 0.2 mcg/kg/hr; titrate to 0.1- 2 mcg/kg/hr. **Note higher dosage range in burn patients.
Adjunct to Analgesia:
Continuous IV infusion:
Initial: 0.2 mcg/kg/hr; titrate to 0.1 to 0.7 mcg/kg/hr
Usual max: 1 mcg/kg/hr
Intranasal:
1-3 mcg/kg/dose intranasal 20-45 minutes prior to procedure. Give half of the total dose into each nostril. Maximum 200 mcg/dose (100 mcg per nostril). If repeat dose is necessary maximum 1 mcg/kg/dose.
Check Nursing Guideline on PHSA SHOP: Intranasal Drug Delivery via Atomizer
Mechanism of Action
Selective alpha-2 adrenergic receptor agonist with sedative, anxiolytic and analgesic effects
Forms Supplied
Injection: 200 mcg/2 mL vial
Standard concentration for infusion: 4 mcg/mL
Standard concentration for infusion: 4 mcg/mL
Comments
An alpha adrenergic receptor agonist with sedative, anxiolytic and analgesic effects.
IV route is restricted to Critical Care Areas, oncology patients receiving dinutuximab infusions and patients under the care of the Acute Pain Service.
Use caution with loading doses as rapid rate of infusion is associated with increased adverse cardiovascular effects (including hypotension, bradycardia and cardiac arrest).
Hypotension and bradycardia may be treated by stopping or decreasing the infusion.
There is no data to support duration of therapy of > 5 days.
For intranasal administration use 100 mcg/mL (200 mcg/2 mL) concentration (undiluted). Refer to PHSA SHOP for Nursing Guideline: Intranasal Drug Delivery via Atomizer
Refer to PHSA SHOP for Procedural Sedation and Analgesia Standards and Guidelines.
References
44, 67, 69, 88, 282, 283, 284, 285, 286
Last Edited
2023-10-15 23:24:43