덱스메데토미딘

알파-2 아드레날린 수용체 작용제

덱스메데토미딘은 수의학에서 주로 진정제, 진통제 및 마취 전 투약으로 사용되는 강력하고 특이적인 **알파-2 아드레날린 수용체 작용제**입니다. 메데토미딘의 우회전성 거울상 이성질체로, 라세미 혼합물보다 약 2배 더 강력합니다.

작용 기전: Dexmedetomidine acts as a highly selective agonist at **pre-synaptic alpha-2 adrenergic receptors** in the central and peripheral nervous systems. * **CNS Effects:** Activation of alpha-2 receptors in the locus coeruleus → decreased norepinephrine release → profound sedation, anxiolysis, and analgesia. * **Cardiovascular Effects:** Activation of peripheral post-synaptic alpha-2B receptors in vascular smooth muscle → intense vasoconstriction → increased systemic vascular resistance (SVR) → reflex bradycardia mediated by baroreceptors. Central alpha-2A activation subsequently decreases sympathetic outflow. * **Other Effects:** Decreases GI secretions, alters intestinal motility, induces diuresis (via inhibition of ADH), and causes mild muscle relaxation.

동물 종별 용량

Cats

Sedation and analgesia · 40 micrograms/kg IM · IM · Single dose · Fasted for 12 hours prior. Apply eye lubricant. Peak effects at 30 minutes.

Dogs

Sedation and analgesia · 375 micrograms/m2 body surface area (BSA) IV; 500 micrograms/m2 BSA IM · IV/IM · Single dose · Microgram/kg dosage decreases as body weight increases. Fast for 12 hours prior. Peak effects at 30 minutes.
Preanesthetic · 125-375 micrograms/m2 IM · IM · Single dose · Accurate dosing not possible < 2 kg.
Premed prior to propofol or face mask induction (geriatric/renal/liver dysfunction) · 62.5 micrograms/m2 · IM/IV · Single dose · Combine with equal volumes of opioid and ketamine.
Slightly heavier sedation for radiographic procedures (ASA II or III) · 125 micrograms/m2 · IM/IV · Single dose · Combine with equal volumes of opioid and ketamine.
Minor surgery, Penn hip or OFA-types of radiographic procedures · 250 micrograms/m2 · IM/IV · Single dose · Combine with equal volumes of opioid and ketamine.
Surgical plane of anesthesia for OHE, castration, or abdominal surgery · 375 micrograms/m2 · IM/IV · Single dose · Combine with equal volumes of opioid and ketamine. Lateral recumbency in 5-8 minutes.
Immobilizing extremely fractious dogs and wolf-hybrid dogs · 500 micrograms/m2 · IM · Single dose · Combine with equal volumes of opioid and ketamine. Rarely required.
Post-operative pain management in critically ill dogs · Loading dose of 25 micrograms/m2 IV, followed by a constant rate infusion for 24 hours at 25 micrograms/m2/hr · IV · CRI · 24 hours · Morphine rescue analgesia may be required.

용량은 면허 수의 전문가를 위한 임상 참고 자료입니다. 항상 최신 라벨과 개별 환자에 대해 확인하십시오.

투여 경로

IMIVOTM (Oral Transmucosal/Buccal)CRI

금기

Cardiovascular disease
Respiratory disorders
Liver or kidney diseases
Shock or severe debilitation
Stress due to extreme heat, cold, or fatigue
Puppies < 16 weeks (US label) or < 6 months (UK label)
Kittens < 12 weeks (US label) or < 5 months (UK label)
Hypersensitivity to the active substance

이상반응

Bradycardia (profound)
Occasional AV blocks
Decreased respiration / Apnea
Hypothermia
Urination
Vomiting
Hyperglycemia
Pain on injection (IM)
Prolonged sedation
Paradoxical excitation
Hypersensitivity
Pulmonary edema
Death from circulatory failure (rare)
Muscle tremors
Transient hypertension
Reduced tear production

약물 상호작용

Anesthetics, Opiates, Sedative/Hypnotics · Effects may be additive; dosage reduction of one or both agents may be required. General anesthetic requirements may be reduced between 30-60%.
Atropine, Glycopyrrolate · Can significantly increase arterial blood pressure and heart rate; use together is not recommended in dogs due to increased cardiac workload.
Epinephrine · Possesses alpha agonist effects; do not use to treat cardiac effects caused by dexmedetomidine.
Yohimbine · May reverse the effects, but atipamezole is preferred for clinical use.

모니터링

Level of sedation and analgesia
Heart rate and rhythm
Blood pressure
Respiration rate and pulse oximetry
Body temperature (monitor for hypothermia)

과용량

Single doses of up to 5X (IV) and 10X (IM) were tolerated in dogs, but adverse effects (heart block, PVCs, tachycardia, profound sedation) can occur. > **Important:** Treatment of dexmedetomidine-induced bradycardia with anticholinergic agents (atropine or glycopyrrolate) is usually **not recommended** due to the risk of severe hypertension and arrhythmias. **Atipamezole** is the safest and most effective choice to reverse any dexmedetomidine-induced effects or overdose.

VetSheet 약물 레퍼런스는 면허 수의 전문가를 위한 임상 의사결정 보조 도구이며, 전문적 판단이나 제조사의 최신 라벨을 대신하지 않습니다.