Dexmedetomidine is a sedative medication intended for intravenous use in clinical settings. An anesthesiologist or care provider with training in sedation usually determines if this medication is appropriate and administers it to the patient. Regulators have approved the drug for use in intensive care units, as well as surgical procedures requiring sedation. It tends to be more expensive than other sedatives, and this may be a consideration when deciding what medication to use.
In low doses, dexmedetomidine reduces anxiety and tension. In higher doses, patients will experience more complete relaxation, sometimes with a euphoric or otherwise altered state. An initial high dose is delivered to induce sedation, and the patient is put on a maintenance dosage to keep the sedation stable until it is no longer needed. When the medication is withdrawn, it wears off quickly and the patient will wake up and become fully responsive.
In intensive care units, patients on mechanical ventilators are sedated. These patients may fight intubation because of the discomfort associated with it. Sedation keeps them calm until they have made therapeutic progress and can be taken out of sedation and weaned off the ventilator. A clinician will adjust the dosage to keep the patient at the right level of sedation. In procedures where sedatives are used, the anesthesiologist can use dexmedetomidine to induce and maintain sedation and will also administer drugs for pain management to keep the patient comfortable.
Unlike many sedatives, dexmedetomidine does not depress respiration, a distinct advantage. It can cause a slow heartbeat and some patients may experience blood pressure fluctuations while on the medication. Care providers carefully monitor patients under sedation for signs of adverse reactions. Drugs are available to reverse sedatives and stabilize patients who start to experience a respiratory or cardiac crisis while under sedation.
This medication can interact badly with other sedatives, as well as alcohol. Before a doctor will prescribe dexmedetomidine and other sedatives, a patient interview is conducted to check for potential risk factors. In an emergency situation where the patient cannot communicate, care providers collect information and make educated guesses about safe treatments for the patient. If a patient appears to develop an adverse reaction, clinicians can step in to provide appropriate intervention and treatment. People who take sedatives for management of seizures and other conditions may want to note them on a medical alert card so first responders and emergency room personnel will be aware if an emergency occurs.
