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dexmedetomidine pharmacokinetics

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https://www.readbyqxmd.com/read/29098392/evaluation-of-pharmacokinetic-models-of-intravenous-dexmedetomidine-in-sedated-patients-under-spinal-anesthesia
#1
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...
November 2, 2017: 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
#2
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
#3
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
https://www.readbyqxmd.com/read/28854538/dexmedetomidine-pharmacokinetic-pharmacodynamic-modelling-in-healthy-volunteers-1-influence-of-arousal-on-bispectral-index-and-sedation
#4
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, such as maintained respiratory drive and production of arousable sedation. We describe development of a pharmacokinetic-pharmacodynamic model of the sedative properties of dexmedetomidine, taking into account the effect of stimulation on its sedative properties. Methods: In a two-period, randomized study in 18 healthy volunteers, dexmedetomidine was delivered in a step-up fashion by means of target-controlled infusion using the Dyck model...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28828532/pharmacokinetic-and-pharmacodynamics-of-intravenous-dexmedetomidine-in-morbidly-obese-patients-undergoing-laparoscopic-surgery
#5
Bo Xu, Dongxu Zhou, Li Ren, Steven Shulman, Xingan Zhang, Ming Xiong
BACKGROUND: This study was designed to investigate the pharmacokinetics and pharmacodynamics of dexmedetomidine in morbidly obese patients undergoing laparoscopic surgery. METHODS: Morbidly obese (body mass index ≥40 kg/m(2)) and normal weight patients scheduled for elective laparoscopic surgery were included (n = 8, each group). After baseline hemodynamic measurement, dexmedetomidine 1 μg/kg was administered over 10 min. General anesthesia was induced with propofol 1...
December 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28663042/pharmacokinetics-of-dexmedetomidine-mk-467-and-their-combination-following-intramuscular-administration-in-male-cats
#6
Bruno H Pypendop, Juhana Honkavaara, Jan E Ilkiw
OBJECTIVE: To characterize the pharmacokinetics of dexmedetomidine, MK-467 and their combination following intramuscular (IM) administration to cats. STUDY DESIGN: Prospective randomized crossover experimental study. ANIMALS: A total of eight healthy adult male castrated cats aged 1-2 years. METHODS: Cats were administered dexmedetomidine (25 μg kg(-1)) IM (treatment D25IM) or intravenously (IV; treatment D25IV); MK-467 (600 μg kg(-1)) IM (treatment MK600IM) or IV (treatment MK600IV); or dexmedetomidine (25 μg kg(-1)) IM with 300, 600 or 1200 μg kg(-1) MK-467 IM (treatments D25MK300IM, D25MK600IM and D25MK1200IM)...
April 9, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28655497/pharmacokinetics-of-dexmedetomidine-in-isoflurane-anesthetized-new-zealand-white-rabbits
#7
Ryan S Bailey, Linda S Barter, Bruno H Pypendop
OBJECTIVE: To characterize the pharmacokinetics of dexmedetomidine when administered as a short intravenous (IV) infusion to isoflurane-anesthetized rabbits. STUDY DESIGN: Experimental study. ANIMALS: A total of six healthy adult female New Zealand White rabbits. METHODS: Rabbits were anesthetized with isoflurane in oxygen. Following determination of isoflurane minimum alveolar concentration (MAC), the anesthetic dose was reduced to 0...
March 6, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28447490/risks-and-benefits-of-pre-operative-dexmedetomidine-in-oral-and-maxillofacial-surgeries-a-systematic-review
#8
REVIEW
Amin Davoudi, Bijan Movahedian Attar, Elham Shadmehr
Oral and maxillofacial surgeries might induce anxiety and pain to the patients. Sedative agents are one of the best ways for eliminating such consequences. Dexmedetomidine (DEX) is a recent sedative agent which presents higher sedative quality with greater specificity than other drugs. The aim of present paper is to evaluate the risks and benefits of administrating DEX during oral and maxillofacial surgeries by reviewing high quality released articles. Areas covered: Searches on PubMed, Scopus and Web of Science databases were completed with focus on randomized controlled trials (RCT)...
June 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#9
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
September 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28105858/hplc-ms-ms-method-for-dexmedetomidine-quantification-with-design-of-experiments-approach-application-to-pediatric-pharmacokinetic-study
#10
Oliwia Szerkus, Wiktoria Struck-Lewicka, Marta Kordalewska, Ewa Bartosińska, Renata Bujak, Agnieszka Borsuk, Agnieszka Bienert, Alicja Bartkowska-Śniatkowska, Justyna Warzybok, Paweł Wiczling, Antoni Nasal, Roman Kaliszan, Michał Jan Markuszewski, Danuta Siluk
AIM: The purpose of this work was to develop and validate a rapid and robust LC-MS/MS method for the determination of dexmedetomidine (DEX) in plasma, suitable for analysis of a large number of samples. METHOD: Systematic approach, Design of Experiments, was applied to optimize ESI source parameters and to evaluate method robustness, therefore, a rapid, stable and cost-effective assay was developed. The method was validated according to US FDA guidelines. LLOQ was determined at 5 pg/ml...
February 2017: Bioanalysis
https://www.readbyqxmd.com/read/28105598/clinical-pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#11
REVIEW
Maud A S Weerink, Michel M R F Struys, Laura N Hannivoort, Clemens R M Barends, Anthony R Absalom, Pieter Colin
Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, and analgesic-sparing effects, and minimal depression of respiratory function. It is potent and highly selective for α2-receptors with an α2:α1 ratio of 1620:1. Hemodynamic effects, which include transient hypertension, bradycardia, and hypotension, result from the drug's peripheral vasoconstrictive and sympatholytic properties. Dexmedetomidine exerts its hypnotic action through activation of central pre- and postsynaptic α2-receptors in the locus coeruleus, thereby inducting a state of unconsciousness similar to natural sleep, with the unique aspect that patients remain easily rousable and cooperative...
August 2017: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/27643584/pharmacokinetics-and-sedative-effects-of-dexmedetomidine-in-dairy-calves
#12
P Cagnardi, R Villa, G Ravasio, L Lucatello, F Di Cesare, F Capolongo, A Boccardo, D Pravettoni
AIMS: To evaluate the pharmacokinetics of dexmedetomidine (DEX) administered I/V at a dose of 5 µg/kg bodyweight in dairy calves and to compare the sedative effects of anaesthetic protocols involving DEX and xylazine. METHODS: Nine dairy calves, aged 17-20 days, were treated with 5 µg/kg I/V dexmedetomidine. For pharmacokinetic evaluation, blood samples were collected over 12 hours and serum samples were analysed by high performance liquid chromatography-mass spectrometry...
January 2017: New Zealand Veterinary Journal
https://www.readbyqxmd.com/read/27595299/pharmacokinetics-and-pharmacodynamics-of-dexmedetomidine
#13
Aiwei Li, Vivian Man Ying Yuen, Sophie Goulay-Dufay, Philip Chi Lip Kwok
Dexmedetomidine is an alpha-2 adrenoceptor agonist and has been used as a general anesthetic, sedative and analgesic for about 30 years. The aim of this paper is to review the pharmacokinetics and pharmacodynamics of dexmedetomidine, evaluate physiological factors that may affect the pharmacokinetics of dexmedetomidine, and summarize the pharmacodynamics of dexmedetomidine at different plasma levels. The pharmacokinetic parameters reported in previous studies according to noncompartmental analyses or population modeling results are compared...
December 2016: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/27221375/the-pharmacokinetics-of-dexmedetomidine-during-long-term-infusion-in-critically-ill-pediatric-patients-a-bayesian-approach-with-informative-priors
#14
Paweł Wiczling, Alicja Bartkowska-Śniatkowska, Oliwia Szerkus, Danuta Siluk, Jowita Rosada-Kurasińska, Justyna Warzybok, Agnieszka Borsuk, Roman Kaliszan, Edmund Grześkowiak, Agnieszka Bienert
The purpose of this study was to assess the pharmacokinetics of dexmedetomidine in the ICU settings during the prolonged infusion and to compare it with the existing literature data using the Bayesian population modeling with literature-based informative priors. Thirty-eight patients were included in the analysis with concentration measurements obtained at two occasions: first from 0 to 24 h after infusion initiation and second from 0 to 8 h after infusion end. Data analysis was conducted using WinBUGS software...
June 2016: Journal of Pharmacokinetics and Pharmacodynamics
https://www.readbyqxmd.com/read/27179189/determination-of-dexmedetomidine-in-children-s-plasma-by-ultra-performance-liquid-chromatography-tandem-mass-spectrometry-and-application-to-pharmacokinetic-study
#15
Hua-Cheng Liu, Wei Sun, Cheng-Yu Wang, Wei-Yang Ying, Li-Dan Zheng, Rui-Feng Zeng, Zhe Wang, Ren-Shan Ge
A rapid, sensitive, and selective ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) was developed and validated for the determination and pharmacokinetic investigation of dexmedetomidine in children's plasma. Sample preparation was accomplished through a simple one-step deproteinization procedure with 0.2mL of acetonitrile to a 0.1mL plasma sample. Plasma samples were separated by UPLC on an Acquity UPLC BEH C18 column using a mobile phase consisting of acetonitrile-0.1% formic acid in water with gradient elution...
June 15, 2016: Journal of Chromatography. B, Analytical Technologies in the Biomedical and Life Sciences
https://www.readbyqxmd.com/read/27037817/population-pharmacokinetics-of-dexmedetomidine-after-short-intravenous-infusion-in-chinese-children
#16
RANDOMIZED CONTROLLED TRIAL
Hua-Cheng Liu, Qing-Quan Lian, Fei-Fei Wu, Cheng-Yu Wang, Wei Sun, Li-Dan Zheng, Jürgen Schüttler, Harald Ihmsen
BACKGROUND AND OBJECTIVE: Dexmedetomidine is a highly selective alpha2-adrenoceptor agonist with sedative and analgesic properties which is also used in pediatric anesthesia. Although the pharmacokinetics of dexmedetomidine have been studied in pediatric patients, there are no data for Chinese children available. As alterations in pharmacokinetics due to ethnicity cannot be ruled out, it was the aim of this study to characterize the pharmacokinetics of dexmedetomidine in Chinese pediatric patients...
April 2017: European Journal of Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/27027842/pharmacokinetics-of-detomidine-following-intravenous-or-oral-transmucosal-administration-and-sedative-effects-of-the-oral-transmucosal-treatment-in-dogs
#17
RANDOMIZED CONTROLLED TRIAL
Kristen M Messenger, Marie Hopfensperger, Heather K Knych, Mark G Papich
OBJECTIVE: To determine the pharmacokinetics of detomidine hydrochloride administered IV (as an injectable formulation) or by the oral-transmucosal (OTM) route (as a gel) and assess sedative effects of the OTM treatment in healthy dogs. ANIMALS: 12 healthy adult dogs. PROCEDURES: In phase 1, detomidine was administered by IV (0.5 mg/m(2)) or OTM (1 mg/m(2)) routes to 6 dogs. After a 24-hour washout period, each dog received the alternate treatment...
April 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27004426/male-patients-require-higher-optimal-effect-site-concentrations-of-propofol-during-i-gel-insertion-with-dexmedetomidine-0-5-%C3%AE-g-kg
#18
Jung Ju Choi, Ji Young Kim, Dongchul Lee, Young Jin Chang, Noo Ree Cho, Hyun Jeong Kwak
BACKGROUND: The pharmacokinetics and pharmacodynamics of an anesthetic drug may be influenced by gender. The purpose of this study was to compare effect-site half maximal effective concentrations (EC50) of propofol in male and female patients during i-gel insertion with dexmedetomidine 0.5 μg/kg without muscle relaxants. METHODS: Forty patients, aged 20-46 years of ASA physical status I or II, were allocated to one of two groups by gender (20 patients per group)...
March 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/26926335/a-forecast-of-relevant-pediatric-sedation-trends
#19
REVIEW
Mohamed Mahmoud, Keira P Mason
PURPOSE OF REVIEW: Over the past decade, the field of pediatric sedation has benefited from contributions which include the introduction and update of policies, procedures, and guidelines regarding training, physiologic monitoring and delivery, the approval of new sedatives, the multispecialty collaborations intended to advance the field and the development of sedatives, and delivery systems. This review will explore new drug innovations as well as evolved formulations of already approved agents, unique sedative delivery systems, the clinical application of pharmacogenetics and will conclude with a reflection on the current and future trends and focus of pediatric sedation research...
March 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/26861990/treatment-of-severe-alcohol-withdrawal
#20
REVIEW
Kyle J Schmidt, Mitesh R Doshi, Jenna M Holzhausen, Allycia Natavio, Megan Cadiz, Jim E Winegardner
OBJECTIVE: Approximately 50% of patients with alcohol dependence experience alcohol withdrawal. Severe alcohol withdrawal is characterized by seizures and/or delirium tremens, often refractory to standard doses of benzodiazepines, and requires aggressive treatment. This review aims to summarize the literature pertaining to the pharmacotherapy of severe alcohol withdrawal. DATA SOURCES: PubMed (January 1960 to October 2015) was searched using the search termsalcohol withdrawal, delirium tremens, intensive care, andrefractory Supplemental references were generated through review of identified literature citations...
May 2016: Annals of Pharmacotherapy
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