덱스메데토미딘
Dexmedetomidine
Dexmedetomidine Hydrochloride
다른 이름: Dexdomitor · Precedex · (S)-medetomidine · MPV 1440 · MPV 295 · MPV 785
VetSheet 수의사 팀 검수업데이트 2026년 4월 5일근거 기반 수의학 참고자료
감사 완료 v13 용량 근거
검토된 비계산 근거검토된 비계산 근거 (2)
근거 표시 전용 — 자동 계산 불가
Light sedation (often used for preanesthesia)
a) Light sedation (often used for preanesthesia): 5 – 15 µg/kg IV, IM, or SC
반드시 함께 고려할 임상 맥락 (7)
- 1. Dexmedetomidine dosages depend on the combination of drugs used and the dosage(s) of the other drug(s). Premedication with dexmedetomidine will significantly reduce the dose of the induction agent required and will reduce volatile anesthetic requirements for maintenance anesthesia. All anesthetic agents used for induction or maintenance of anesthesia should be administered to effect.
- 2. Dose adjustments will also need to be made to account for the degree of desired sedation; type, duration, and pain level of the procedure; and patient temperament and body weight/size.
- 3. Dosing based on body surface area (BSA; or allometric scaling) is not common in clinical practice but decreases the variability in drug response between giant/large and small/toy breed dogs. See Conversion Tables: Body Weight (kg) to Body Surface Area (m 2 ).
- 4. For all dosages, the low end of the dose range is generally appropriate for IV administration, whereas the mid-upper range is most appropriate for IM or SC administration. Higher dosages will provide more profound sedation and analgesia.
- 5. When SC administration is used, the speed of sedation is slower, and the level of sedation is lighter and inconsistent. For more predictable sedation, IM or IV administration is recommended.
- 6. The effects of dexmedetomidine can be reversed with atipamezole. It is most often dosed by volume at ½ or the same volume of dexmedetomidine that was administered and given IM. See Atipamezole.
- Store the injection at room temperature (ie, 15°C-30°C [59°F-86°F]); do not freeze. Discard unused product 90 days after first piercing the vial.
근거 표시 전용 — 자동 계산 불가
Deep sedation
c) Deep sedation: 40 µg/kg IV, IM, or SC
반드시 함께 고려할 임상 맥락 (7)
- 1. Dexmedetomidine dosages depend on the combination of drugs used and the dosage(s) of the other drug(s). Premedication with dexmedetomidine will significantly reduce the dose of the induction agent required and will reduce volatile anesthetic requirements for maintenance anesthesia. All anesthetic agents used for induction or maintenance of anesthesia should be administered to effect.
- 2. Dose adjustments will also need to be made to account for the degree of desired sedation; type, duration, and pain level of the procedure; and patient temperament and body weight/size.
- 3. Dosing based on body surface area (BSA; or allometric scaling) is not common in clinical practice but decreases the variability in drug response between giant/large and small/toy breed dogs. See Conversion Tables: Body Weight (kg) to Body Surface Area (m 2 ).
- 4. For all dosages, the low end of the dose range is generally appropriate for IV administration, whereas the mid-upper range is most appropriate for IM or SC administration. Higher dosages will provide more profound sedation and analgesia.
- 5. When SC administration is used, the speed of sedation is slower, and the level of sedation is lighter and inconsistent. For more predictable sedation, IM or IV administration is recommended.
- 6. The effects of dexmedetomidine can be reversed with atipamezole. It is most often dosed by volume at ½ or the same volume of dexmedetomidine that was administered and given IM. See Atipamezole.
- Store the injection at room temperature (ie, 15°C-30°C [59°F-86°F]); do not freeze. Discard unused product 90 days after first piercing the vial.
용량은 수의사 전문가를 위한 임상 참고자료입니다. 반드시 최신 약물 정보 및 개별 환자에 따라 확인하시기 바랍니다.
개요
덱스메데토미딘은 수의학에서 주로 진정제, 진통제 및 마취 전 투약으로 사용되는 강력하고 특이적인 알파-2 아드레날린 수용체 작용제입니다. 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.
안전성·주의사항
금기사항
- 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
부작용
- 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
주의
Cardiovascular Warning: Due to pronounced cardiovascular effects (bradycardia, vasoconstriction), only clinically healthy dogs and cats should be treated.
- Seizure Disorders: Use with caution in animals with or prone to developing seizures; may lower the seizure threshold.
- Ocular Care: Blinking may be impaired and tear production reduced; eye lubricants should be applied during sedation.
- Pregnancy/Nursing: Not recommended for use in pregnant or breeding animals unless benefits clearly outweigh risks (FDA Category C). Safe use during nursing is not established.
약물 상호작용
Effects may be additive; dosage reduction of one or both agents may be required. General anesthetic requirements may be reduced between 30-60%.
Can significantly increase arterial blood pressure and heart rate; use together is not recommended in dogs due to increased cardiac workload.
Possesses alpha agonist effects; do not use to treat cardiac effects caused by dexmedetomidine.
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)
약동학
반감기
흡수
Dogs: IM bioavailability 60%, peak plasma levels in ~35 minutes. Cats: IM peak plasma levels in ~15 minutes. OTM (buccal) administration provides similar clinical effects to IM.
분포
Dogs: Vd is 0.9 L/kg. Cats: Vd is 2.2 L/kg.
대사
Primarily metabolized in the liver via glucuronidation and N-methylation. No active metabolites.
배설
Eliminated primarily in the urine and to a lesser extent in the feces.
과다투여
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.
제품
제형
- Injection: 0.5 mg/mL (500 mcg/mL)
- Concentrated Solution for Injection: 100 mcg/mL
동물용의약품
- Dexmedetomidine HCl 0.5 mg/mL (500 micrograms/mL) in 10 mL multidose vials (Dexdomitor)
인용의약품
- Dexmedetomidine HCl Concentrated Solution for Injection: 100 micrograms/mL in 2 mL vials (Precedex)
규제 현황
규제 데이터 없음: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
보관·안정성
Store the injection at room temperature (15-30°C); do not freeze. Can be mixed in the same syringe with butorphanol, ketamine, buprenorphine, hydromorphone, or morphine with no pharmacological risk.
보호자 정보
이 약물은 수의학 전문가에 의해서만 투여 및 모니터링되어야 합니다. 보호자는 특히 노령견이나 기저 질환이 있는 개에서 발생할 수 있는 잠재적인 부작용을 인지해야 합니다. 진정 후에는 반려동물을 따뜻하고 조용하게 유지하십시오.
VetSheet 의약품 참고자료는 수의사 전문가의 임상 의사결정 지원을 위한 것이며, 전문적 판단이나 제조사의 최신 약물 정보를 대체할 수 없습니다.