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dexmedetomidine pharmacokinetics

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https://www.readbyqxmd.com/read/29782406/population-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-in-children-undergoing-ambulatory-surgery
#1
María-Gabriela Pérez-Guillé, Alejandra Toledo-López, Liliana Rivera-Espinosa, Radames Alemon-Medina, Chiharu Murata, Ismael Lares-Asseff, Juan Luis Chávez-Pacheco, Josefina Gómez-Garduño, Ana-Lilia Zamora Gutiérrez, Claudia Orozco-Galicia, Karina Ramírez-Morales, Gustavo Lugo-Goytia
BACKGROUND: Dexmedetomidine (DEX) is an α-2 adrenergic agonist with sedative and analgesic properties. Although not approved for pediatric use by the Food and Drug Administration, DEX is increasingly used in pediatric anesthesia and critical care. However, very limited information is available regarding the pharmacokinetics of DEX in children. The aim of this study was to investigate DEX pharmacokinetics and pharmacodynamics (PK-PD) in Mexican children 2-18 years of age who were undergoing outpatient surgical procedures...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29755192/efficacy-and-pharmacokinetics-of-bupivacaine-with-epinephrine-or-dexmedetomidine-after-intraperitoneal-administration-in-cats-undergoing-ovariohysterectomy
#2
Javier Benito, Beatriz Monteiro, Francis Beaudry, Paulo Steagall
The aim of this study was to determine the efficacy and pharmacokinetics of bupivacaine in combination with epinephrine or dexmedetomidine after intraperitoneal administration in cats undergoing ovariohysterectomy. Sixteen healthy adult cats (3.3 ± 0.6 kg) were included in a prospective, randomized, masked clinical trial after obtaining owners' consent. Anesthetic protocol included buprenorphine-propofol-isoflurane. Meloxicam [0.2 mg/kg body weight (BW)] was administered subcutaneously before surgery. Cats were randomly divided into 2 groups to receive 1 of 2 treatments...
April 2018: Canadian Journal of Veterinary Research, Revue Canadienne de Recherche Vétérinaire
https://www.readbyqxmd.com/read/29704051/correction-to-evaluation-of-pharmacokinetic-models-of-intravenous-dexmedetomidine-in-sedated-patients-under-spinal-anesthesia
#3
Shinju Obara, Tsuyoshi Imaizumi, Takahiro Hakozaki, Atsuyuki Hosono, Yuzo Iseki, Norie Sanbe, Masahiro Murakawa
Inadvertently, the reference [8] was published incorrectly in the original publication of the article. The correct reference [8] is provided below.
April 27, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29679228/recovery-time-after-oral-and-maxillofacial-ambulatory-surgery-with-dexmedetomidine-an-observational-study
#4
Belen Hernando, Antonio Martinez-Simon, Elena Cacho-Asenjo, Iñaki F Troconiz, Cristina Honorato-Cia, Alfredo Panadero, Luis L Naval, Jorge M Nuñez-Cordoba
OBJECTIVES: To evaluate the relationship between pharmacokinetic descriptors of dexmedetomidine (predicted area under the curve during the procedure, predicted plasma level at the end of the procedure, and duration of procedure) and sedation depth (proportion of time with bispectral index < 85 during the procedure) with recovery time after ambulatory procedures. MATERIALS AND METHODS: Clinical observational study of patients undergoing oral and maxillofacial ambulatory surgery with dexmedetomidine as sole sedative agent...
April 20, 2018: Clinical Oral Investigations
https://www.readbyqxmd.com/read/29666901/subcutaneously-administered-dexmedetomidine-is-efficiently-absorbed-and-is-associated-with-attenuated-cardiovascular-effects-in-healthy-volunteers
#5
P Uusalo, D Al-Ramahi, I Tilli, R A Aantaa, M Scheinin, T I Saari
PURPOSE: Palliative care patients often need sedation to alleviate intractable anxiety, stress, and pain. Dexmedetomidine is used for sedation of intensive care patients, but there is no prior information on its subcutaneous (SC) administration, a route that would be favored in palliative care. We compared the pharmacokinetics and cardiovascular, sympatholytic, and sedative effects of SC and intravenously (IV) administered dexmedetomidine in healthy volunteers. METHODS: An open two-period, cross-over design with balanced randomization was used...
April 17, 2018: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29661414/dexmedetomidine-metabolic-clearance-is-not-affected-by-fat-mass-in-obese-patients
#6
A Rolle, S Paredes, L I Cortínez, B J Anderson, N Quezada, S Solari, F Allende, J Torres, D Cabrera, V Contreras, J Carmona, C Ramírez, A M Oliveros, M Ibacache
BACKGROUND: Obesity has been associated with reduced dexmedetomidine clearance, suggesting impaired hepatic function or reduced hepatic blood flow. The aim of this study was to clarify the effect of obesity in dexmedetomidine metabolic clearance. METHODS: Forty patients, ASA I-III, 18-60 yr old, weighing 47-126 kg, scheduled for abdominal laparoscopic surgery, were enrolled. Anaesthetic agents (propofol, remifentanil, and dexmedetomidine) were dosed based on lean body weight measured by dual X-ray absorptiometry...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661413/pharmacokinetic-and-pharmacodynamic-study-of-intranasal-and-intravenous-dexmedetomidine
#7
A Li, V M Yuen, S Goulay-Dufaÿ, Y Sheng, J F Standing, P C L Kwok, M K M Leung, A S Leung, I C K Wong, M G Irwin
BACKGROUND: Intranasal dexmedetomidine produces safe, effective sedation in children and adults. It may be administered by drops from a syringe or by nasal mucosal atomisation (MAD NasalTM ). METHODS: This prospective, three-period, crossover, double-blind study compared the pharmacokinetic (PK) and pharmacodynamic (PD) profile of i.v. administration with these two different modes of administration. In each session each subject received 1 μg kg-1 dexmedetomidine, either i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29661383/does-intranasal-dexmedetomidine-provide-adequate-plasma-concentrations-for-sedation-in-children-a-pharmacokinetic-study
#8
J W Miller, R Balyan, M Dong, M Mahmoud, J E Lam, J N Pratap, J R Paquin, B L Li, J P Spaeth, A Vinks, A W Loepke
BACKGROUND: Atomised intranasal dexmedetomidine administration is an attractive option when sedation is required for paediatric diagnostic procedures, as vascular access is not required. The risk of haemodynamic instability caused by dexmedetomidine necessitates better understanding of its pharmacokinetics in young children. To date, intranasal dexmedetomidine pharmacokinetics has only been studied in adults. METHODS: Eighteen paediatric patients received dexmedetomidine 1 or 2 μg kg-1 intranasally or 1 μg kg-1 i...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29599632/comparison-of-the-effects-of-dexmedetomidine-on-the-induction-of-anaesthesia-using-marsh-and-schnider-pharmacokinetic-models-of-propofol-target-controlled-infusion
#9
Wan Mohd Nazaruddin Wan Hassan, Hai Siang Tan, Rhendra Hardy Mohamed Zaini
Background: The study aimed to determine the effects of dexmedetomidine on the induction of anaesthesia using different models (Marsh and Schnider) of propofol target-controlled infusion (TCI). Methods: Sixty-four patients aged 18-60 years, American Society of Anaesthesiologists (ASA) class I-II who underwent elective surgery were randomised to a Marsh group ( n = 32) or Schnider group ( n = 32). All the patients received a 1 μg/kg loading dose of dexmedetomidine, followed by TCI anaesthesia with remifentanil at 2 ng/mL...
February 2018: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29595531/sedative-and-analgesic-drug-sequestration-after-a-single-bolus-injection-in-an-ex-vivo-extracorporeal-membrane-oxygenation-infant-circuit
#10
Viviane G Nasr, Jonathan Meserve, Luis M Pereira, David Faraoni, Steve Brediger, Susan Goobie, Ravi Thiagarajan, James A DiNardo
Patient sedation and analgesia on extracorporeal membrane oxygenation (ECMO) is vital for safety and comfort. However, adsorption to the circuit may alter drug pharmacokinetics and remains poorly characterized. This study characterizes drug adsorption of morphine, fentanyl, midazolam, and dexmedetomidine in an ex vivo infant ECMO circuit utilizing polymethylpentene (PMP) membrane oxygenator (MO) with protein-bounded polyvinylchloride (PVC) tubing. Twelve closed-loop ex vivo ECMO circuits were prepared using P...
March 26, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29495085/pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine-induced-vasoconstriction-in-healthy-volunteers
#11
Pekka Talke, Brian J Anderson
AIMS: Alpha-2 agonists are direct peripheral vasoconstrictors, which achieve these effects by activating vascular smooth muscle alpha-2 adrenoceptors. The impact of this response during dexmedetomidine infusion remains poorly quantified. Our goal was to investigate the pharmacokinetic (PK) and pharmacodynamic (PD, vasoconstriction) effects of a computer-controlled dexmedetomidine infusion in healthy volunteers. METHODS: After local ethics committee approval, we studied 10 healthy volunteers...
March 1, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29413570/pharmacokinetics-of-bupivacaine-with-dexmedetomidine-or-epinephrine-after-intraperitoneal-administration-in-cats
#12
J Benito, B Monteiro, F Beaudry, P Steagall
No abstract text is available yet for this article.
September 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29393492/dexmedetomidine-impairs-p%C3%A2-glycoprotein%C3%A2-mediated-efflux-function-in-l02-cells-via-the-adenosine-5-%C3%A2-monophosphate%C3%A2-activated-protein-kinase-nuclear-factor%C3%A2-%C3%AE%C2%BAb-pathway
#13
Guo-Rong He, Xiao-Kun Lin, Yong-Biao Wang, Cong-De Chen
Dexmedetomidine (DEX) a type of the anaesthetic that has been widely used in anaesthesia and intensive care. However, whether DEX affects the pharmacokinetics of drugs remains elusive. As hepatic P‑glycoprotein (P‑gp) serves a critical role in the disposition of drugs, the present study aimed to address whether P‑gp function could be affected by DEX in vitro. In the present study, L02 cells (a normal human liver cell line) were exposed to DEX for 24 h and P‑gp function was evaluated by the intracellular accumulation of Rhodamine 123...
April 2018: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29290034/pharmacokinetics-of-dexmedetomidine-during-analgosedation-in-icu-patients
#14
Piotr Smuszkiewicz, Paweł Wiczling, Justyna Ber, Justyna Warzybok, Tomasz Małkiewicz, Jan Matysiak, Agnieszka Klupczyńska, Iwona Trojanowska, Zenon Kokot, Edmund Grześkowiak, Wojciech Krzyzanski, Agnieszka Bienert
Dexmedetomidine (DEX) is a fairly new alfa2 -agonist which has been increasingly used in recent years for analgosedation, mostly because it offers a unique ability of providing both moderate level of sedation and analgesia without respiratory depression. Despite of many papers published, there are still only a few concerning the PK of the drug given as long-term infusion in ICU patients. The aim of this work was to characterize the population pharmacokinetics of dexmedetomidine and to investigate the potential benefits of individualization of drug dosing based on patient characteristics in the heterogeneous group of medical and surgical patients staying in intensive care unit...
April 2018: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/29247451/pharmacokinetics-of-dexmedetomidine-administered-to-patients-with-end-stage-renal-failure-and-secondary-hyperparathyroidism-undergoing-general-anaesthesia
#15
W Zhong, Y Zhang, M-Z Zhang, X-H Huang, Y Li, R Li, Q-W Liu
WHAT IS KNOWN AND OBJECTIVE: The primary objective of this study was to compare the pharmacokinetics of dexmedetomidine in patients with end-stage renal failure and secondary hyperparathyroidism with those in normal individuals. METHOD: Fifteen patients with end-stage renal failure and secondary hyperparathyroidism (Renal-failure Group) and 8 patients with normal renal and parathyroid gland function (Control Group) received intravenous 0.6 μg/kg dexmedetomidine for 10 minutes before anaesthesia induction...
December 16, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29226340/is-there-a-place-for-dexmedetomidine-in-equine-anaesthesia-and-analgesia-a-systematic-review-2005-2017
#16
REVIEW
M Gozalo-Marcilla, F Gasthuys, S P L Luna, S Schauvliege
The objective of this review was to perform a literature compilation of all the equine publications that used dexmedetomidine as the first article on this topic was published, in 2005. We also aimed to answer the question whether the use of dexmedetomidine can currently be justified. For that, we compiled information from databases, such as PubMed, Google Scholar and Web of Science and the proceedings of the last veterinary anaesthesiology meetings. Dexmedetomidine is an attractive drug to be used in horses, mainly due to its pharmacokinetic profile and pharmacodynamics that favour its use as intravenous constant rate infusion (CRI)...
April 2018: Journal of Veterinary Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29206695/drug-induced-sleep-endoscopy-from-obscure-technique-to-diagnostic-tool-for-assessment-of-obstructive-sleep-apnea-for-surgical-interventions
#17
Joshua H Atkins, Jeff E Mandel
PURPOSE OF REVIEW: Provide a practical update on drug-induced sleep endoscopy (DISE) for anesthesia providers, which can also serve as a reference for those preparing to establish a DISE program. RECENT FINDINGS: New developments in surgical approaches to OSA and the growing global incidence of the condition have stimulated increased interest and demand for drug-induced sleep endoscopy. New techniques include transoral robotic surgery and hypoglossal nerve stimulation...
February 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29098392/evaluation-of-pharmacokinetic-models-of-intravenous-dexmedetomidine-in-sedated-patients-under-spinal-anesthesia
#18
Shinju Obara, Tsuyoshi Imaizumi, Takahiro Hakozaki, Atsuyuki Hosono, Yuzo Iseki, Norie Sanbe, Masahiro Murakawa
PURPOSE: Little information is available on the predictive ability of previously published pharmacokinetic models of dexmedetomidine in patients under spinal anesthesia. We evaluated nine published pharmacokinetic models that were constructed in different study settings. METHODS: Sixteen patients received dexmedetomidine infusions after spinal anesthesia according to the manufacturer's recommended regimen (6 µg/kg/h over 10 min followed by 0.2-0.7 µg/kg/h) or target-controlled infusion (initial target of 1...
February 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29049110/evidence-for-the-efficacy-of-systemic-opioid-sparing-analgesics-in-pediatric-surgical-populations-a-systematic-review
#19
REVIEW
Alyssa Zhu, Hubert A Benzon, T Anthony Anderson
While a large number of studies has examined the efficacy of opioid-sparing analgesics in adult surgical populations, fewer studies are available to guide postoperative pain treatment in pediatric patients. We systematically reviewed available publications on the use of systemic nonopioid agents for postoperative analgesia in pediatric surgical populations. A comprehensive literature search identified meta-analyses and randomized controlled trials (RCTs) assessing the effects of systemic, nonopioid agents on postoperative narcotic requirements or pain scores in pediatric surgical populations...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28854543/dexmedetomidine-pharmacodynamics-in-healthy-volunteers-2-haemodynamic-profile
#20
P J Colin, L N Hannivoort, D J Eleveld, K M E M Reyntjens, A R Absalom, H E M Vereecke, M M R F Struys
Background: Dexmedetomidine, a selective α 2 -adrenoreceptor agonist, has unique characteristics, with little respiratory depression and rousability during sedations. We characterized the haemodynamic properties of dexmedetomidine by developing a pharmacokinetic-pharmacodynamic (PKPD) model with a focus on changes in mean arterial blood pressure (MAP) and heart rate. Methods: Dexmedetomidine was delivered i.v. to 18 healthy volunteers in a step-up fashion by target-controlled infusion using the Dyck model...
August 1, 2017: British Journal of Anaesthesia
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