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Dexmedetomidine

Dexmedetomidine: Mechanism of Action and Adverse Side Effects Central Nervous System Dexmedetomidine is a highly-selective, direct α2-adrenoceptor agonist Peripheral Vascular System Binds to the pre and post junctional α2 receptors in the dorsal horn of the spinal cord Binds to transmembrane α2 receptors at the locus ceruleus in the brain stem Stimulation of arterial transmembrane α2 receptors Inhibits adenylate cyclase intracellularly ↓ Cell membrane protein phosphorylation Altered ion channel activity Hyperpolarization of neuronal cell membranes Termination of nociceptor (pain) signal propagation Analgesia ↑ Sedation Anxiety suppression ↓ Formation of cyclic AMP (cAMP) ↓ cAMP-dependent kinase activity Neuronal firing suppression, mimicking endogenous sleep ↓Cerebral blood flow ↓ Sympathetic tone Heart block and asystole Maintenance of seizure foci on EEG in seizure surgeries ↑ Smooth muscle contraction ↑ Vasoconstriction Transient hypertension and reflexive bradycardia on bolus administration ↓ Heart rate and systemic vascular resistance Bradycardia & hypotension Authors: Kayleigh Yang, Arzina Jaffer Reviewers: Priyanka Grewal, Luiza Radu Leyla Baghirzada * MD at time of publication Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Published Nov 21, 2024 on www.thecalgaryguide.com