Detomidine

> **Detomidine** is a potent alpha-2 adrenergic agonist used primarily in equine medicine for its profound sedative and analgesic properties. * **Potency:** It is approximately 50 to 100 times more potent than xylazine. * **Clinical Use:** Widely used for standing sedation, minor surgical procedures, and analgesia (especially for colic) in horses. It has also been used off-label in cattle, small ruminants, camelids, and birds. * **Important Caveat:** Even when horses appear deeply sedated, they may still respond suddenly to external stimuli (e.g., kicking). The addition of an opioid (like butorphanol) can help temper this startle response and improve the quality of sedation.

กลไกการออกฤทธิ์: Detomidine acts as a potent and highly specific agonist at **alpha-2 adrenergic receptors** in the central and peripheral nervous systems. * **Sedation & Analgesia:** Activation of presynaptic alpha-2 receptors in the locus coeruleus and dorsal horn of the spinal cord → inhibition of norepinephrine release → decreased sympathetic outflow, resulting in profound sedation, muscle relaxation, and analgesia. * **Cardiovascular Effects:** Initial activation of peripheral postsynaptic alpha-2 receptors → transient vasoconstriction and **hypertension** → compensatory vagal reflex → profound **bradycardia** and potential AV block. Central sympatholytic effects then lead to a prolonged decrease in blood pressure.

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