Introduction:
Structure: C13H17CIN2 Pharmacology/Pharmacokinetics: Comparing Alpha2 Agonists
Dosing:
Absorption/Distribution/Metabolism/Excretion:
Significant Drug/Drug Interactions:
Toxicity/Mechanism of Toxicity:
Treatment/Management:
By Dr. Patrick Jackson, MD References: ∗ Albertson T, Chenoweth J, Ford J, et. al. Is it prime time for alpha2-adrenocepter agonists in the treatment of withdrawal syndromes? J Med Toxicol. 2014; 10(4):369-381. ∗ Bryczkowski S, Lopreiato M, Yonclas P, et. al. Risk factors for delirium in older trauma patients admitted to the surgical intensive care unit. J Trauma Acute Care Surg. 2014; 77(6):944-951. ∗ Crispo A, Daley M, Pepin J, Harford P, Brown C. Comparison of clinical outcome in nonintubated patients with severe alcohol withdrawal syndrome treated with continuous-infusion sedatives: Dexmedetomidine versus benzodiazepines. Pharmacotherapy. 2014; 34(9):910-917. ∗ DeMuro J, Botros D, Wirkoski E, Hanna A. Use of dexmedetomidine for the treatment of alcohol withdrawal syndrome in critically ill patients: A retrospective case series. J Anesth. 2012; 26(4)601-605. ∗ Flower O, Hellings S. Sedation in traumatic brain injury. Emerg Med Int. 2012; e-published. ∗ Lizotte R, Kappes J, Barte B, et. al. Evaluating the effects of dexmedetomidine compared to propofol as adjunctive therapy in patients with alcohol withdrawal. Clin Pharmacol. 2014; 31(6):171-177. ∗ Lonardo N, Mone M, Nirula R, et. al. Propofol is associated with favorable outcomes compared with benzodiazepines in ventilated intensive care unit patients. American Journal of Respiratory and Critical Care Medicine. 2014; 189(11):1383-1394. ∗ Mancl E, Brophy G. Time to wake up: A historical perspective on modernized sedation management. Society of Critical Care Medicine. 2013; e-published. ∗ Mazanikov M, Udd M, Kylanpaa L, et. al. Dexmedetomidine impairs success of patient-controlled sedation in alcoholics during ERCP: A randomized, double blind, placebo-controlled study. Surg Endosc. 2013; 27(6):2163-2168. ∗ Muller S, Preslaski C, Kiser T, et. al. A randomized, double-blind, placebo-controlled dose range study of dexmedetomidine as adjunctive therapy for alcohol withdrawal. Crit Care Med. 2014; 42(5):1131-1139. ∗ Muzyk A, Kerns S, Brudney S, Gagliardi J. Dexmedetomidine for the treatment of alcohol withdrawal syndrome: Rationale and current status of research. CNS Drugs. 2013; 27(11):913-920. ∗ Rayner S, Weinert C, Jepsen S, Broccard A. Dexmedetomidine as adjunct treatment for severe alcohol withdrawal in the ICU. Ann Intensive Care. 2012; 23(1):12. ∗ Riihioja P, Jaatinen P, Haapalinna A, et. al. Effects of dexmedetomidine on rat locus coeruleus and ethanol withdrawal symptoms during intermittent ethanol exposure. Alcohol Clin Exp Res. 1999; 23(3):432-438. ∗ Riihioja P, Jaatinen P, Oksanen H, et. al. Dexmedetomidine, diazepam, and propranolol in the treatment of ethanol withdrawal symptoms in the rat. Alcohol Clin Exp Res. 1997; 21:801-804. ∗ Roberts D, Hall R, Kramer A, et. al. Sedation for critically ill adults with severe traumatic brain injury: A systematic review of randomized controlled trails. Crit Care Med. 2011; 39(12)2743-2751. ∗ Tolonen J, Rossinen J, Alho H, Harjola V. Dexmedetomidine in addition to benzodiazepine-based sedation in patients with alcohol withdrawal delirium. Eur J Emerg Med. 2013; 20(6):425-427. ∗ Traeger J, Popa A, Makii J. Dexmedetomidine for acute alcohol withdrawal. Society of Critical Care Medicine. 2014, e-published. ∗ Savel R, Kupfer Y. Using dexmedetomidine as adjunctive therapy for patients with severe alcohol withdrawal syndrome: Another piece of the puzzle. Crit Care Med. 2014; 42(5)1298-1299. ∗ VanderWeide L, Foster C, MacLaren R, et. al. Evaluation of early dexmedetomidine addition to the standard of care for severe alcohol withdrawal in the ICU: A retrospective controlled cohort study. J Intensive Care Med. 2014; e-published. ∗ Wong A, Benedict N, Kane S. Multicenter evaluation of pharmacologic management and outcomes associated with severe resistant alcohol withdrawal. J Crit Care. 2015; 30(2):405-409.
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