Early Sedation with Dexmedetomidine in Critically Ill Patients

New England Journal of Medicine, Год журнала: 2019, Номер 380(26), С. 2506 - 2517

Опубликована: Май 19, 2019

Dexmedetomidine produces sedation while maintaining a degree of arousability and may reduce the duration mechanical ventilation delirium among patients in intensive care unit (ICU). The use dexmedetomidine as sole or primary sedative agent undergoing has not been extensively studied.

Язык: Английский

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Dexmedetomidine for reduction of atrial fibrillation and delirium after cardiac surgery (DECADE): a randomised placebo-controlled trial

The Lancet, Год журнала: 2020, Номер 396(10245), С. 177 - 185

Опубликована: Июль 1, 2020

Язык: Английский

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GPCR drug discovery: new agents, targets and indications

Nature Reviews Drug Discovery, Год журнала: 2025, Номер unknown

Опубликована: Март 3, 2025

Язык: Английский

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Clinical Assessment and Management of Delirium in the Palliative Care Setting

Drugs, Год журнала: 2017, Номер 77(15), С. 1623 - 1643

Опубликована: Сен. 1, 2017

Delirium is a neurocognitive syndrome arising from acute global brain dysfunction, and prevalent in up to 42% of patients admitted palliative care inpatient units. The symptoms delirium its associated communicative impediment invariably generate high levels patient family distress. Furthermore, with significant morbidity increased mortality many populations, especially where refractory common the dying phase. As clinical diagnosis frequently missed by healthcare team, case for regular screening arguably very compelling. Depending on precipitating factors, episode often reversible, earlier stages life-threatening illness. Until recently, antipsychotics have played pivotal role management, but this now requires critical re-evaluation light recent research that failed demonstrate their efficacy mild- moderate-severity occurring patients. Non-pharmacological strategies management play fundamental should be optimized through collective efforts whole interprofessional team. Refractory agitated last days or weeks life may require use pharmacological sedation ameliorate distress patients, which juxtaposed increasing members. Further evaluation multicomponent prevention treatment population urgently required.

Язык: Английский

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Baclofen therapeutics, toxicity, and withdrawal: A narrative review

SAGE Open Medicine, Год журнала: 2021, Номер 9

Опубликована: Янв. 1, 2021

Baclofen is an effective therapeutic for the treatment of spasticity related to multiple sclerosis, spinal cord injuries, and other pathologies. It has been increasingly used off-label management several disorders, including musculoskeletal pain, gastroesophageal reflux disease, alcohol use disorder. therapy associated with potential complications, life-threatening toxicity withdrawal syndrome. These disorders require prompt recognition a high index suspicion. While these complications can develop following administration either oral or intrathecal baclofen, risk greater route. The baclofen largely supportive while syndrome most effectively treated re-initiation supplementation dosing. Administration pharmacologic adjuncts may be required treat symptoms. This narrative review provides overview historical emerging uses offers practical dosing recommendations both routes administration, reviews diagnosis withdrawal.

Язык: Английский

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Mechanisms of Dexmedetomidine in Neuropathic Pain

Frontiers in Neuroscience, Год журнала: 2020, Номер 14

Опубликована: Май 5, 2020

Dexmedetomidine is a new-generation, highly selective α2 adrenergic receptor agonist with large number of advantages, including its sedative and analgesic properties, ability to inhibit sympathetic nerves, reduced anesthetic dosage, hemodynamic stability, mild respiratory depression abilities improve postoperative recognition. Its safety effectiveness, as well provide certain degree comfort patients, make it useful adjuvant for wide range clinical applications. For example, dexmedetomidine commonly used in patients undergoing general anesthesia, also exerts effects during tracheal intubation or mechanical ventilation intensive care unit patients. In recent years, the deepening research on dexmedetomidine, drug still applied treatment spastic pain, myofascial neuropathic complex pain syndrome chronic headache multimodal analgesia. However, we must note that appropriateness patient dose selection should be given attention when using this drug; furthermore, observed adverse reactions such hypotension bradycardia. Therefore, effectiveness long-term use remain studied. addition, basic experimental studies have found can protect important organs, brain, heart, kidney, liver lung, through various mechanisms, anti-sympathetic effects, inhibition apoptosis oxidative stress reduction inflammatory response. Moreover, neuroprotective properties received most from scholars. Hence, review, mainly focus characteristics applications especially role nervous system relief pain.

Язык: Английский

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Mitochondrial biogenesis as a therapeutic target for traumatic and neurodegenerative CNS diseases

Experimental Neurology, Год журнала: 2020, Номер 329, С. 113309 - 113309

Опубликована: Апрель 11, 2020

Язык: Английский

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Recent Advances in the Clinical Value and Potential of Dexmedetomidine

Journal of Inflammation Research, Год журнала: 2021, Номер Volume 14, С. 7507 - 7527

Опубликована: Дек. 1, 2021

Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has sedative, anxiolytic, analgesic, sympatholytic, and opioid-sparing properties induces unique sedative response which shows an easy transition from sleep to wakefulness, thus allowing patient be cooperative communicative when stimulated. Recent studies indicate several emerging clinical applications via different routes. We review recent data on dexmedetomidine studies, particularly exploring the varying routes of administration, experimental implications, effects, comparative advantages over other drugs. A search was conducted PubMed Web Science libraries for using combinations words "dexmedetomidine", "route administration", pharmacological effect. The current routes, application categories are presented. It functions by stimulating pre- post-synaptic α2-adrenoreceptors within central nervous system, leading hyperpolarization noradrenergic neurons, induction inhibitory feedback loop, reduction norepinephrine secretion, causing sympatholytic effect, in addition its anti-inflammation, induction, bowel recovery, sore throat effects. Compared with similar agonists, both pharmacodynamics advantage significantly greater α2:α1-adrenoceptor affinity ratio pharmacokinetic having shorter elimination half-life. In application, been reported present significant number benefits including safe sedation various surgical interventions, improvement intraoperative postoperative analgesia, compromised airways without respiratory depression, nephroprotection stability hypotensive hemodynamics, nausea vomiting shivering incidence, decrease blood loss. Although is promising, it still limited further research required enhance understanding properties, selection, dosage, adverse

Язык: Английский

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Dexmedetomidine post-conditioning alleviates myocardial ischemia–reperfusion injury in rats by ferroptosis inhibition via SLC7A11/GPX4 axis activation

Human Cell, Год журнала: 2022, Номер 35(3), С. 836 - 848

Опубликована: Фев. 25, 2022

Язык: Английский

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The Current Role of Dexmedetomidine as Neuroprotective Agent: An Updated Review

Brain Sciences, Год журнала: 2021, Номер 11(7), С. 846 - 846

Опубликована: Июнь 25, 2021

Dexmedetomidine, selective α2-adrenergic agonist dexmedetomidine, has been widely used clinically for sedation and anesthesia. The role of dexmedetomidine an interesting topic neonatological anesthetic research since a series advantages such as enhancing recovery from surgery, reducing opioid prescription, decreasing sympathetic tone, inhibiting inflammatory reactions, protecting organs, were reported. Particularly, increasing number animal studies have demonstrated that ameliorates the neurological outcomes associated with various brain spinal cord injuries. In addition, growing clinical trials reported efficacy rates postoperative dysfunction, delirium stroke, which strongly highlights possibility functioning neuroprotective agent future use. Mechanism linked dexmedetomidine’s properties its modulation neuroinflammation, apoptosis, oxidative stress, synaptic plasticity via receptor, dependently or independently. By reviewing recent advances preclinical evidence on effects we hope to provide complete understanding above mechanism insights into potential this in use patients.

Язык: Английский

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