Induction Agent: Dexmedetomadine Flashcards
Dexmedetomidine is commonly known by which brand name?
A) Versed
B) Precedex
C) Diprivan
D) Anectine
B) Precedex
Slide 17
MOA
Dexmedetomidine (Precedex) primarily works by stimulating which type of receptor?
A) Beta-adrenergic receptors
B) NMDA receptors
C) Alpha-2 adrenergic receptors
D) GABA receptors
C) Alpha-2 adrenergic receptors
…causes pre-synaptic inhibition. (Turns down the SNS).
Slide 17
Matching
Match the Alpha-2 adrenergic receptor subtype with its effect
› α2A: Sedation, Hypnosis, Sympatholysis
› α2B: Vasoconstriction, Anti-shivering, Analgesia, Ca linked– may be excitatory
› α2C: Learning, Startle response
17
Which of the following are common uses of Dexmedetomidine in clinical practice?
Select 3
A) ICU sedation
B) Cardiovascular surgery
C) Postoperative pain management
D) Anesthesia induction for general surgery
E) TIVA
A) ICU sedation
B) Cardiovascular surgery
E) Total intravenous anesthesia (TIVA)
17
To achieve a final concentration of 4 mcg/cc, the 2 cc vial of Dexmedetomidine (100 mcg/cc) is typically mixed with:
A) 10 cc normal saline
B) 20 cc normal saline
C) 50 cc normal saline
D) 100 cc normal saline
C) 50 cc normal saline
A step further:
To achieve a total volume of 50 cc, you will need to add diluent (e.g., saline) to the initial 2 cc of Dexmedetomidine. The amount of diluent to add is:
DiluentVolume = FinalVolume − InitialVolume
Dilutent Volume = 50cc − 2cc = 48 cc
17
The loading dose for Dexmedetomidine is typically ________ mcg/kg, given over 10 minutes.
A) 0.5
B) 1
C) 1.5
D) 2
B) 1mcg/kg
17
If loading dose is administered too quickly, Dexmedetomidine may initially cause:
A) Hypotension
B) Tachycardia
C) Bradycardia
D) Hypertension
D) Hypertension
This is transient and is attenuated by giving is slowly.
17
B) 0.2–0.7 mcg/kg/hr
Slide 17
Dexmedetomidine is considered respiratory-sparing among induction agents because it has:
A) High respiratory depressant effects
B) Minimal respiratory depressant effects
C) Complete respiratory stimulation
D) Strong respiratory depression, similar to opioids
B) Minimal respiratory depressant effects
the least of all the induction drugs. Sleep like depression.
Slide 18
Even though Dexmedetomidine has minimal respiratory effects, it is essential to monitor for obstruction, particularly in patients with __________.
A) Asthma
B) Diabetes
C) Sleep apnea
D) Hypertension
C) Sleep apnea
still not protected airway – especially in obese
Which of the following describes a potential side effect of Dexmedetomidine related to airway management?
A) It provides complete airway protection.
B) It can cause an anti-sialogogic effect.
C) It requires intubation for safety.
D) It increases respiratory rate.
B) It can cause an anti-sialogogic effect (dry mouth)
Slide 18
While using Dexmedetomidine, patients typically show __________ in arterial blood gases (ABG), tidal volume (TV), and respiratory rate (RR).
A) Significant changes
B) Severe decreases
C) No significant changes
D) Rapid increases
C) No significant changes
(alcoholic withdrawal under anesthesia is almost 50% fatal)
Dexmedetomidine is beneficial for patients experiencing drug and alcohol withdrawal under anesthesia because:
A) It reduces the risk of fatal outcomes
B) It causes intense sedation without any respiratory effects.
C) It increases muscle rigidity.
D) It reduces hallucinations
A) It reduces the risk of fatal outcomes
Alcohol withdrawal under anesthesia has an almost __________ fatality rate.
A) 10%
B) 25%
C) 50%
D) 75%
C) 50%
One of the benefits of using Dexmedetomidine in patients on high doses of opioids is:
A) Increased salivation
B) Decreased muscle rigidity
C) Enhanced respiratory rate
D) Increased blood pressure
B) Decreased muscle rigidity
