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The FDA-approved indications for dexmedetomidine are sedation of intubated and mechanically ventilated patients in the intensive care unit (ICU) and peri-procedural (or peri-operative) sedation of non-intubated patients. Over time, usage has expanded to off-label uses, including treatment and prevention of delirium, adjunctive analgesia, therapy for insomnia in the ICU, and treatment of alcohol withdrawal. Dexmedetomidine has also been used in peripheral nerve blocks to prolong the duration of analgesia. This activity will highlight the mechanism of action, adverse event profile, pharmacology, monitoring, and relevant interactions of dexmedetomidine, pertinent for members of the interprofessional team in treating patients where anesthesia is appropriate. Objectives: Identify the mechanism of action of dexmedetomidine. Summarize the indicated uses for dexmedetomidine. Review the adverse effect profile and contraindications of dexmedetomidine. Explain the importance of improving care coordination among the interprofessional team to enhance care delivery for patients when using dexmedetomidine as an anesthesia agent. Access free multiple choice questions on this topic.
Dexmedetomidine is a useful non-opioid drug used to manage pain and sedation in the ICU and operating room. The drug is effective, but its use does require monitoring of vital signs. Both the pharmacist and clinician should ensure the administration of the right dose to prevent adverse effects. ICU nurses should know that the drug requires caution in patients with heart failure. All these disciplines working collaboratively as an interprofessional healthcare team will optimize outcomes when using dexmedetomidine. [Level 5] The primary downside to dexmedetomidine is its cost.