Analgesics/NSAIDS - Dexmedetomidine (Precedex) Flashcards
- What is the maximum dose of Dexmedetomidine (Precedex) that can be given per kilogram of body weight for a small intraoperative case?
A) 0.2 mcg/kg
B) 0.4 mcg/kg
C) 0.5 mcg/kg
D) 1.0 mcg/kg
C) 0.5 mcg/kg
-Small intraoperative doses: 4 mcg at a time to a max of 0.5 mcg/kg for case
TxWes Reference:
On Hand: 200 mcg/2 mL
Mix in NS 48 mL
Concentration: 4 mcg/mL
Bolus 0.5-1 mcg/kg over 10 mins
then 0.2 - 0.7 mcg/kg/hr
During an infusion of Dexmedetomidine (Precedex), what is the typical dose range administered per kilogram per hour?
A) 0.1-0.5 mcg/kg/hr
B) 0.2-0.8 mcg/kg/hr
C) 0.3-1.0 mcg/kg/hr
D) 0.4-1.2 mcg/kg/hr
B) 0.2-0.8 mcg/kg/hr
TxWes Reference:
On Hand: 200 mcg/2 mL
Mix in NS 48 mL
Concentration: 4 mcg/mL
Bolus 0.5-1 mcg/kg over 10 mins
then 0.2 - 0.7 mcg/kg/hr
What is the typical dose range of Dexmedetomidine (Precedex) for intranasal administration per kilogram of body weight?
A) 0.5-1 mcg/kg
B) 1-2 mcg/kg
C) 2-3 mcg/kg
D) 3-4 mcg/kg
B) 1-2 mcg/kg
-Intranasal: 1-2 mcg/kg (usually between 75-100 mcg split between both nares) you’ll put the undiluted amount into a 3 mL syringe and then fill the rest up with NS to total 3 mLs) (won’t see at ARMC but used elsewhere)
For intranasal administration, how much Dexmedetomidine (Precedex) is usually administered in total, divided between both nares?
A) 50-75 mcg
B) 75-100 mcg
C) 100-150 mcg
D) 150-200 mcg
B) 75-100 mcg
-Intranasal: 1-2 mcg/kg (usually between 75-100 mcg split between both nares) you’ll put the undiluted amount into a 3 mL syringe and then fill the rest up with NS to total 3 mLs) (won’t see at ARMC but used elsewhere)
What is the concentration of Dexmedetomidine?
200 mcg/2mL mixed in 50 mL NS bag = 4 mcg/mL solution
TxWes Reference:
On Hand: 200 mcg/2 mL
Mix in NS 48 mL
Concentration: 4 mcg/mL
Bolus 0.5-1 mcg/kg over 10 mins
then 0.2 - 0.7 mcg/kg/hr
What is the primary mechanism by which Dexmedetomidine (Precedex) exerts its sedative effects?
A) Dopamine receptor agonism
B) Alpha-1 antagonist activity
C) Alpha-2 agonism at post-synaptic receptors
D) Beta-adrenergic receptor stimulation
Answer: C) Alpha-2 agonism at post-synaptic receptors
MOA: Alpha-2 agonist; sedative actions believed to be mediated primarily by post-synaptic alpha-2 receptors, resulting in decreased NE levels, producing sedative and analgesic effects. Plasma NE concentrations decrease by 72% (range of 40-97%), which results in sympatholytic effects
When preparing a dose of Dexmedetomidine (Precedex) for intranasal administration, how should the solution be prepared if the total volume is to be 3 mL?
A) Mix the undiluted drug with 3 mL of sterile water.
B) Mix the undiluted drug with 3 mL of normal saline (NS).
C) Mix 1 mL of undiluted drug with 2 mL of sterile water.
D) Mix the undiluted drug with 2 mL of normal saline (NS) and 1 mL of sterile water.
B) Mix the undiluted drug with 3 mL of normal saline (NS).
-Intranasal: 1-2 mcg/kg (usually between 75-100 mcg split between both nares) you’ll put the undiluted amount into a 3 mL syringe and then fill the rest up with NS to total 3 mLs) (won’t see at ARMC but used elsewhere)
What is the concentration of Dexmedetomidine (Precedex) in a solution prepared by mixing 200 mcg of the drug in a 2 mL volume with 50 mL of normal saline (NS)?
A) 2 mcg/mL
B) 4 mcg/mL
C) 6 mcg/mL
D) 10 mcg/mL
B) 4 mcg/mL
Concentration: 200 mcg/2mL mixed in 50 mL NS bag = 4 mcg/mL solution
By what percentage do plasma norepinephrine (NE) concentrations decrease due to the action of Dexmedetomidine (Precedex)?
A) 20-40%
B) 40-60%
C) 60-80%
D) 40-97%
D) 40-97%
MOA: Alpha-2 agonist; sedative actions believed to be mediated primarily by post-synaptic alpha-2 receptors, resulting in decreased NE levels, producing sedative and analgesic effects. Plasma NE concentrations decrease by 72% (range of 40-97%), which results in sympatholytic effects
What is the typical onset time for Dexmedetomidine (Precedex) when administered?
A) 1 minute
B) 3 minutes
C) 5 minutes
D) 10 minutes
C) 5 minutes
When does Dexmedetomidine (Precedex) generally reach its peak effect after administration?
A) 5-10 minutes
B) 10-15 minutes
C) 20-30 minutes
D) 30-45 minutes
C) 20-30 minutes
What is the approximate half-life of Dexmedetomidine (Precedex)?
A) 1-2 hours
B) 2-3 hours
C) 4-5 hours
D) 6-7 hours
B) 2-3 hours
How is Dexmedetomidine (Precedex) primarily metabolized and eliminated from the body?
A) Primarily excreted unchanged in urine and feces
B) Almost complete biotransformation in the liver with minimal unchanged drug in urine
C) Complete biotransformation in the kidneys with minimal unchanged drug in feces
D) Excreted unchanged in the urine and biotransformed in the liver
B) almost Complete biotransformation in the liver with minimal unchanged drug in urine
Almost a complete biotransformation (liver) with very little unchanged being excreted in urine (95%) and feces (4%).
What is a primary use of Dexmedetomidine (Precedex) during intraoperative management?
A) To provide pain control as a primary anesthetic
B) To act as an adjunct for pain control and sedation
C) To induce rapid induction of anesthesia
D) To provide muscle relaxation
B) To act as an adjunct for pain control and sedation
What is one of the key sedative properties of Dexmedetomidine (Precedex)?
A) Analgesic effects only
B) Anxiolysis, sedation antisialogogue, volatile agent-sparing properties, sympatholytic
C) Muscle relaxation
D) Neuromuscular blockade
B) Anxiolysis, sedation antisialogogue, volatile agent-sparing properties, sympatholytic (you’ll see decrease in HR)
