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Dexmedetomidine

ffelis
Contributor(s):

Linda Horspool

Synonym(s): Dextrorotatory enantiomer of medetomidine; S-enantiomer of medetomidine


Introduction

Name

  • Dexmedetomidine hydrochloride.

Class of drug

  • Alpha 2 adrenergic agonist.

Description

Chemical name

  • [+]4-[1-[2,3-dimethylphenyl]-ethyl]-1H-imidazole
  • (S)-4(5)-[1-(2,3-Dimethylphenyl) ethyl]imidazole tartrate

Molecular formula

  • C13H16N2.HCl

Molecular weight

  • 236.7

Physical properties

  • White or almost white powder that is freely soluble in water and has a pKa of 7.1. Its partition coefficient in octanol: water at pH 7.4 is 2.89.
  • Supplied as a clear, colorless solution for injection with methyl parahydroxybenzoate (E 218, 1.6 mg/ml) and propyl parahydroxybenzoate (E 216, 0.2 mg/ml) as excipients.

Storage requirements

  • May be stored for 28 days at 25°C after withdrawal of the first dose.
  • Do not freeze.

Uses

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Administration

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Pharmacokinetics

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Precautions

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Interactions

with other drugs

  • Induction agents (eg propofol   Propofol  , thiopental   Thiopental  ):
    • Premedication with dexmedetomidine will significantly reduce the dosage of the induction agent (by 30% to 60%, depending on the agent).
    • Attention should be given during the administration of intravenous induction drugs to effect.
  • Ketamine:
    • In cats, concurrent administration of ketamine (5 mg/kg) increases the plasma concentrations of and the total exposure to dexmedetomidine (0.04 mg/kg) and
    • Tachycardia may occur when dexmedetomidine (0.04 mg/kg) and letamine (10 mg/kg) are used concurrently.
    • In cats, vomiting, hypothermia and nervousness and occasionally AV block or extrasystole when used within 10 minutes of dexmedetomidine.
  • Volatile anesthetics:
    • Requirements for maintenance anesthesia are reduced.
  • Opioid analgesics   Analgesia: opioid  :
    • Vasodilators (eg angiotensin-converting-enzyme inhibitors) and negative chronotropes (eg Beta-Blockers) may potentiate the effects of dexmedetomidine. Do not use in animals with cardiovascular disorders.
    • Central nervous system depressants, such as tricyclic antidepressants (eg clomipramine link:Clomipramine), may potentiate the effects of dexmedetomidine. Dose adjustment should be made.

with diagnostic tests

  • Alpha2-agonists increase blood glucose concentration.

Adverse Reactions

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Further Reading

Publications

Refereed Papers

  • Recent references from PubMed and VetMedResource.
  • Monteiro E R, Campagnol D, Parrilha L R, Furlan L Z (2009) Evaluation of cardiorespiratory effects of combinations of dexmedetomidine and atropine in cats.J Feline Med Surg [Epub ahead of print] PubMed.
  • Granholm M, McKusick B C, Westerholm F C, Aspegren J C (2007) Evaluation of the clinical efficacy and safety of intramuscular and intravenous doses of dexmedetomidine and medetomidine in dogs and their reversal with atipamezole. Vet Rec 160 (26), 891-897 PubMed.
  • Granholm M, McKusick B C, Westerholm F C, Aspegren J C (2006) Evaluation of the clinical efficacy and safety of dexmedetomidine or medetomidine in cats and their reversal with atipamezole. Vet Anaesth Analg 33 (4), 214-223 PubMed.
  • Murrell J C, Hellebrekers L J (2005) Medetomidine and dexmedetomidine: a review of cardiovascular effects and antinociceptive properties in the dog.Vet Anaesth Analg 32 (3), 117-127.
  • Mendes G M, Selmi A L, Barbudo-Selmi G R, Lins B T, Figueiredo J P (2003) Clinical use of dexmedetomidine as premedicant in cats undergoing propofol-sevoflurane anaesthesia. J Feline Med Surg 5 (5), 265-270 PubMed.  
  • Selmi A L, Mendes G M, Lins B T, Figueiredo J P, Barbudo-Selmi G R (2003)Evaluation of the sedative and cardiorespiratory effects of dexmedetomidine, dexmedetomidine-butorphanol, and dexmedetomidine-ketamine in cats. JAVMA 222 (1), 37-41 PubMed.
  • Ansah O B, Raekallio M, Vainio O (1998)Comparison of three doses of dexmedetomidine with medetomidine in cats following intramuscular administration. J Vet Pharmacol Ther 21 (5),  380-387. 

Other sources of information

  • Murrell J (2009) Dexmedetomidine (Dexdomitor®). UK Vet 14, 43-48.
  • Association of Veterinary Anaesthetists (2009) Dexmedetomidine publications: ava.eu.com Accessed March 4, 2009.
  • EMEA(2008) Summary of Product Characteristics of Dexdomitor: www.emea.europa.eu Accessed March 4, 2009.
  • Murrell, J (2009)Dexmedetomidine in cardiac disease: whats the controversy?: www.ava.eu.com Accessed March 4, 2009.
  • National Office of Animal Health(2009) Datasheet for Dexdomitor:  www.noahcompendium.co.uk Accessed March 4, 2009.

Organisation(s)

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