Indications for PRECEDEX:
For sedation of initially intubated and mechanically ventilated patients during treatment in an intensive care setting. For sedation of non-intubated patients prior to and/or during surgical and other procedures.
Individualize. Give by continuous infusion not to exceed 24hrs. Initiation of ICU sedation: give loading infusion of 1mcg/kg over 10 minutes; patients converting from alternate sedative therapy: a loading dose may not be required; >65yrs, hepatic impairment: reduce dose. Maintenance of ICU sedation: 0.2–0.7mcg/kg/hr; >65yrs, hepatic impairment: reduce dose. Initiation of procedural sedation: loading infusion of 1mcg/kg over 10 minutes, less invasive procedures: 0.5mcg/kg over 10 minutes; awake fiberoptic intubation patients: loading infusion of 1mcg/kg over 10 minutes; >65yrs: loading infusion of 0.5mcg/kg over 10 minutes; hepatic impairment: reduce dose. Maintenance of procedural sedation: initially 0.6mcg/kg/hr and titrated to achieve desired effect with doses ranging from 0.2–1mcg/kg/hr; awake fiberoptic intubation patients: 0.7mcg/kg/hr until endotracheal tube is secured; >65yrs, hepatic impairment: reduce dose.
<18yrs: not established.
Should be administered by persons skilled in management of patients in intensive care or operating room setting. Advanced heart block and/or severe ventricular dysfunction. Hypovolemia, diabetes, chronic hypertension, elderly: increased risk of bradycardia and hypotension. Hepatic impairment. Withdrawal symptoms (w. infusions >24hrs that are abruptly stopped). Labor & delivery: not studied. Pregnancy (Cat.C). Nursing mothers.
Additive effects with other vasodilators, negative chronotropic agents, anesthetics, sedatives, hypnotics, opioids; consider reducing dose. Incompatible with amphotericin B or diazepam; avoid co-administration.
Hypotension, bradycardia, dry mouth; sinus arrest, transient hypertension (w. loading dose).