Precedex dosing card pdf

The resultant decreases in heart rate and systemic vascular resistance indirectly decrease cardiac output and systolic blood pressure. Intravenous iv and intramuscular im dosing on the basis of body weight. Precedex dexmedetomidine hydrochloride injection is a sterile, nonpyrogenic solution suitable for intravenous infusion following dilution. Loading dose of 1 mcgkg iv infusion over 10 minutes. The prescriber is responsible for the verification of indications and dosages listed in the manufacturers package insert for the individual drugs, from which most information for this dosing guide is obtained. Bsa dosing is recommended for drugs with high selectivity and specificity such as dexmedetomidine. Sep 05, 2016 in this episode ill discuss how to use dexmedetomidine in severe alcohol withdrawal. Ketamine sedation protocol for emergency and critical care. Adult critical care intravenous infusions titration protocol. Precedex dexmedetomidine hydrochloride dose, indications. Dexmedetomidine is notable for its ability to provide sedation without risk of respiratory depression unlike other commonly used drugs such as propofol and fentanyl and can provide cooperative or semirousable sedation. Nov 09, 2018 precedex is a sedative that is used to sedate a patient who is under intensive medical care and needs a mechanical ventilator breathing machine. May 30, 2011 however, clonidine is only a mild sedative and can result in significant hemodynamic compromise.

Administer precedex using a controlled infusion device. Assessment algorithm for sedated adult icu patients icu. Adverse reaction information is derived from the continuous infusion trials of precedex for sedation in the intensive care unit setting in which 1007 adult patients received precedex. Clinical application, the use of dexmedetomidine in intensive care sedation yahya shehabi, john a. As discussed in episode 70 on severe alcohol withdrawal, dexmedetomidine reduces sympathetic outflow and blunts many of the symptoms of alcohol withdrawal, including tremor tachycardia anxiety agitation. Dosing based on body surface area bsa provides predictable. Dexmedetomidine exhibits a biphasic blood pressure response in a dosedependent fashion. The tube is then attached to the ventilator, which pumps. A maintenance infusion was then started, with an average dose of 1. Initial dose including awake fiberoptic intubation. Although dexmedetomidine is labeled for sedation in critically ill patients at doses up.

Dosing guidelines precedex dosing should be individualized and titrated to desired clinical response. When the patient is awake, show this card with the faces. Reduction of the dose may be required compatability 0. Procedural sedation and analgesia resources psa is the use of analgesics, sedatives, and dissociative agents to perform urgent painful and emotionally challenging procedures on patients in a humane, safe and controlled fashion.

Clinical application, the use of dexmedetomidine in. Dexmedetomidine use in pediatric intensive care and. Precedex dexmedetomidine hydrochloride pfizer canada. Precedex should be administered by continuous infusion not to exceed 24 hours. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Call for listeners to submit practice resources every oddnumbered episode i share a resource that i use in my daily practice. Dosing based on body surface area bsa provides predictable effects. Is a viable alternative sedativehypnotic agent for procedural sedation in the ed mark estrellado md, pgy3. Listing a study does not mean it has been evaluated by the u. Before a ventilator is used, a breathing tube must be inserted through the mouth and into the patients airway, a procedure called intubation. Dexmedetomidine, sold under the trade name precedex among others, is an anxiety reducing, sedative, and pain medication. Sep 06, 2014 in early scientific theory of adrenergic mechanisms, it was believed that adrenergic receptors were classified into 2 groups.

Although dexmedetomidine is labeled for sedation in. Preparation of solutions is the same, whether for the loading dose or maintenance infusion. Dexmedetomidine for sedation in the intensive care unit. Coadministration of dexmedetomidine could lead to enhancement of effects of anaesthetics, sedatives, hypnotics and opioids. Although this is common clinical practice, there is limited clinical data to demonstrate the efficacy of this technique and to provide clonidine dosing guidelines. Dexmedetomidine precedex for severe alcohol withdrawal. Dilute the 200 mcg2 ml 100 mcgml vial contents in 0. Teiken, md, surgical and combined intensive care units gary e. Each 1 ml of precedex contains 118 mcg of dexmedetomidine hcl equivalent to 100 mcg dexmedetomidine base and 9. Clinical application, the use of dexmedetomidine in intensive. This agent has a short circulating halflife and has significantly fewer hemodynamic side effects than clonidine. Given the regularity of noninvasive and minimally invasive procedures that emergency physicians must perform on a daily basis, proficiency in the art of procedural sedation remains an indispensable component of their already broad repertoire of skills. Although dexmedetomidine appears to be effective for sedation in children based on limited data, 4 of 10 infants and children who started with a dexmedetomidine infusion of 0.

Use of clonidine to prevent withdrawal following prolonged. Mar 16, 2020 precedex dexmedetomidine hydrochloride injection is a sterile, nonpyrogenic solution suitable for intravenous infusion following dilution. Precedex is not indicated for infusions lasting longer than 24 hours. Dexmedetomidine hydrochloride injection safely and. Withdraw 2 ml of 100 mcgml dexmedetomidine and add to 48 ml of 0. Mar 31, 2015 use of clonidine to prevent withdrawal following prolonged dexmedetomidine infusions the safety and scientific validity of this study is the responsibility of the study sponsor and investigators.

The median total dexmedetomidine infusion dose over the first 24 hours was. Explain to the person that each face is for a person who feels happy because he has no pain hurt or sad because he has some or. Serumlevelsmaybedrawn68hrafteradoseisadministered,although theyare usually drawn immediatelybeforethenextdose. Complete data for 11 patients were analyzed for alcohol withdrawal scoring. They measured the duration of time spent at the desired level of sedation on the richmond agitationsedation scale and duration of mechanical ventilation primary outcomes, as well as numerous secondary outcomes. Precedex is supplied as a clear, colorless, isotonic solution with a ph of 4. By contrast, dexmedetomidine precedex, a more potent alpha2 receptor agonist, is potentially a more effective adjunctive therapy. Precedex injection, 200 mcg2 ml 100 mcgml precedex must be diluted with 0. To prepare the infusion, withdraw 2 ml of precedex injection, and add to 48. The investigators clinical practice makes use of oral clonidine as a means of transitioning from intravenous dexmedetomidine following prolonged infusions more than 35 days. Dexmedetomidine as adjunct treatment for severe alcohol. Please consult a qualified health professional for more detailed information. I would love to hear from you on what resources you use, so i can share with all of the listeners. The solution is preservativefree and contains no additives or chemical stabilizers.

Dexmedetomidine precedex, hospira, lake forest, il is a centrally acting 2 receptor agonist that can be titrated to the desired level of sedation without significant respiratory depression. Pharmacology, adverse reactions, warnings and side effects. With administration up to 7 days, regardless of dose, 12 5% precedex adult subjects experienced at least 1 event related to withdrawal within the first 24 hours after discontinuing study drug and 7 3% precedex adult subjects experienced at least 1 event 24 to 48 hours after end of study drug. Download fulltext pdf download fulltext pdf download fulltext pdf use of dexmedetomidine for pain control article pdf available in f medicine reports 21.

Precedex dosing should be individualized and titrated to desired clinical response. Precedex should be administered using a controlled infusion device. Precedex prescription and dosage sizes information for physicians and healthcare professionals. Precedex should be administered only by persons skilled in the management of patients in the intensive care or operating room setting. Product communicationcanadian regulations limit the scope of information we are permitted to give on prescription drugs via the internet or other means. In addition to its cardiovascular properties, dexmedetomidine possesses anxiolytic, hypnoticsedative, anesthetic. Dexmedetomidine is an alpha2adrenergic agonist sedative agent. Indicated for sedation of nonintubated patients before andor during surgical and other procedures.

Precedex is a sedative that is used to sedate a patient who is under intensive medical care and needs a mechanical ventilator breathing machine. Outside of rapid iv administration, ketamine has minimal effects on respiratory drive. Each 1 ml of precedex contains 118 mcg of dexmedetomidine hcl equivalent to 100 mcg dexmedetomidine base and 9 mg of sodium chloride in water. Information in this booklet should be used as a guide only. Please contact pfizer canada medical information at 1 800 4636001 with any comments or inquiries. Procedural sedation and analgesia resources core em. Find patient medical information for precedex intravenous on webmd including its uses, side effects and safety, interactions, pictures, warnings and user ratings. Precedex, dexmedetomidine dosing, indications, interactions. It is not necessary to discontinue precedex prior to extubation. In contrast, the median total infusion dose over the first 24 hours was 9. Pocket reference for icu staff critical care medicine services 2000 2nd edition tripler army medical center honolulu, hi prepared by. Rapid iv administration of ketamine can cause brief periods of apnea. Forty children received a dexmedetomidine loading dose average total dose 2.

Mar 16, 2020 adverse reaction information is derived from the continuous infusion trials of precedex for sedation in the intensive care unit setting in which 1007 adult patients received precedex. Capitals indicate lifethreatening, underlines indicate most frequent. Explain to the person that each face is for a person. Icu sedation guidelines of care icu sedation 2009 icu pain management protocol selfreporting pain assessment scale wongbaker faces pain rating scale directions.

Dexmedetomidine is notable for its ability to provide sedation without risk of respiratory depression unlike other commonly used drugs such as propofol and fentanyl and can provide cooperative or semirousable sedation similar to clonidine, it is a sympatholytic drug that. Precedex as good as versed or propofol jama pulmccm. Precedex is currently marketed in the usa for shortterm use as a potent perioperative sedative and analgesic. Provided dosing ranges are general guidelines and are. The average time to sedation was 50 12 min with oral dosing and 14 8 min with iv dosing. Precedex fda prescribing information, side effects and uses. Individualize and titrate precedex dosing to desired clinical effect. Side effects of precedex dexmedetomidine hydrochloride.