Does Naloxone Reverse the Sedation of Dexmedetomidine?
Howard Greller, MD Dexmedetomidine (Dex) is a selective a-2 adrenoreceptor agonist that has found acceptance in a variety of clinical settings including adult and pediatric ICU sedation, neurosurgery, pediatric procedural sedation, as an adjunct to fiber-optic intubation, cardiac surgery and bariatric surgery. The most significant side effects noted during its use as a sedative are hypotension and bradycardia. It appears to have less prevalent respiratory depression when compared to opioid administration. It is currently approved for sedation in intubated patients for a period of 24 hours (little data available.) With its increasing use, medication errors and therapeutic misadventures are likely to occur. Clonidine is an imidazoline pharmaceutical with a similar mechanism to action to dexmedetomidine. Dex has an a-2:a-1 receptor affinity ratio of 1600:1 (compared to clonidine), an elimination half-life of 2 hours (vs 8 hours) and a a-distribution half-life of 6 minutes, making it a pot