Dexmedetomidine

(S) -4 - [1 - (2,3- dimethylphenyl ) ethyl] -3H -imidazo

QN05CM18

Sedative

α2 -adrenoceptor agonist

Hydrochloride

Template: Infobox chemical / molecular formula search available

Dexmedetomidine is the active isomer of medetomidine, which is used as a sedative.

Mechanism of Action

Activated like clonidine, dexmedetomidine dose dependently α2 -adrenoceptors and thus reduces the release of noradrenaline. This occurs particularly in the locus coeruleus in the brain stem, which is a natural control center for attention and alertness. This allows you to turn the particular type of dexmedetomidine sedation explain: It is a relatively natural sleep-like state from which the patient can wake up immediately when spoken to and are able to communicate or to follow instructions. Furthermore, α2 -adrenoceptors the sympathetic nervous system are activated, which leads to its inhibition ( sympathectomy ).

Compared to other sedatives

In considering the application as a sedative in the ICU, dexmedetomidine has the advantage of better controllability of sedation and duration (compared to benzodiazepines ), and the advantage of a possible long-term use over several weeks (compared to propofol ). Furthermore, a habit and therefore a possible dependence development low ( in comparison to benzodiazepines and opiates ).

Effect

In addition to its sedative dexmedetomidine property is believed to act via an altered pain processing and pain-relieving ( analgesic ), anxiolytic and muscle relaxant.

As an aside, it comes with the usual low doses in the inhibition of the sympathetic nervous system sympathetic blockade to decrease heart rate and blood pressure reduction. At high concentrations, such as can occur during rapid intravenous injections briefly, outweighs the peripheral vasoconstrictive effects of dexmedetomidine, so that there is an increase in blood pressure.

Application

Dexmedetomidine is approved in Germany for the sedation of adult, intensive care patients treated. Within studies, experiences exist for use in children in the context of off- label use.

Trade names

• Dexdomitor Dexdor