Dexmedetomidine

Question 1

What is the brand/trade name for dexmedetomidine?

Answer 1

• Precedex

_{UpToDate - Dexmedetomidine: Drug Information}

Question 2

What is the pharmacologic category/class of dexmedetomidine?

Answer 2

• Sedative
• Alpha-2 adrenergic agonist

_{UpToDate - Dexmedetomidine: Drug Information}

Question 3

What is the mechanism of action of dexmedetomidine?

Answer 3

Brain Stem: decreased alertness
alpha 2 agonism

• ↓ calcium mediated release of norepinephrine
• postsynaptic potassium efflux & hyperpolarization

Spinal Cord: analgesia
alpha-2 agonism

• ↓ calcium mediated release of glutamate
• postsynaptic potassium efflux → neuronal hyperpolarization

_{Nagelhout (7th), p. 1300
UpToDate - Dexmedetomidine: Drug Information}

Question 4

What is the ED₉₅ dose of rocuronium?

Answer 4

• 0.3 mg/kg

Dose that causes, on average, 95% supression of twitch height

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 5

What is the typical dosing range of rocuronium to rapidly achieve good intubating conditions?

Answer 5

• 0.6-1 mg/kg IV
• RSI up to 1.2 mg/kg

Intubating doses of NMBA are usually 2-3x the ED₉₅

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 6

What is the onset of action for rocuronium?

Answer 6

• 60-90 seconds

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 7

What is the duration of action for rocuronium?

Answer 7

• 30-60 minutes — intermediate acting

_{Nagelhout (7th ed.), pp. 158 - Table 12.4, 169 - Table 12.10}

Question 8

Which organ(s) are responsible for rocuronium’s clearance (metabolism/elimination)?

Answer 8

• Metabolism: Liver → bile unchanged
• Elimination: Kidneys

_{Anesthesia Guidebook - Episode 17: Anesthesia Top Drawer Run Down - Part 1
Nagelhout (7th ed.), pp. 157, 169 - Table 12.10}