Induction

Dexmedetomidine

Alpha-2 agonist (centrally selective) · Precedex

Mechanism: Highly selective α2-adrenoceptor agonist — sedation, analgesia, sympatholysis.

Calculate dose for your patient

Enter weight (kg or lb). Always verify before administration.

Patient weight

Computed weight

70.0 kg · 154.3 lb

Loading dose

35 mcg – 70 mcg

= 8.75–17.50 mL (4 mcg/mL)

Over 10 min. Often omitted to avoid hemodynamic swings.

Weight is saved on this device for the next calculator you open.

Full dose calculator

Onset

5–10 min

Duration

60–120 min after infusion stop

Metabolism

Hepatic; conjugation & CYP2A6.

Dosing

Adult

Load: 1 mcg/kg over 10 min (often omitted). Infusion: 0.2–0.7 mcg/kg/h.

Pediatric

0.5–1 mcg/kg load, infusion 0.2–1 mcg/kg/h.

Indications

ICU sedation
Procedural sedation
Awake fiberoptic intubation
PONV adjunct

Contraindications

Advanced heart block (without pacemaker)

Side Effects

Bradycardia
Hypotension (or transient HTN with bolus)
Dry mouth

Clinical Pearls

1Sedation that preserves respiratory drive — ideal for awake intubation.

2Skip the load in elderly / cardiac patients to avoid hemodynamic swings.

References & Further Reading

1
Textbook
Flood P, Rathmell JP, Shafer S. Stoelting's Pharmacology and Physiology in Anesthetic Practice. 5th ed. Philadelphia: Wolters Kluwer; 2015.
2
Textbook
Gropper MA, Miller RD, Cohen NH, et al., eds. Miller's Anesthesia. 9th ed. Philadelphia: Elsevier; 2020.
3
Textbook
Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC, Ortega R, Sharar SR, Holt NF. Clinical Anesthesia. 8th ed. Philadelphia: Wolters Kluwer; 2017.
4
Textbook
Adriano A, Morris R, eds. 2021 CA-1 Tutorial Textbook (15th Ed.). Stanford University Medical Center, Department of Anesthesiology.

Citations are provided to direct further study. Always check the most current edition of guidelines and society recommendations — the information in this chapter is a teaching summary, not primary source material.