Prommer Eric
Mayo Clinic College of Medicine.
Am J Hosp Palliat Care. 2011 Jun;28(4):276-83. doi: 10.1177/1049909110389804. Epub 2010 Dec 3.
Dexmedetomidine, is a α( 2) adrenergic agonist approved by the Food and Drug administration for sedation and analgesia. A highly potent α(2) adrenergic agonist, it has quick onset of action, with peak effects within 1 hour of administration. It is metabolized in the liver and eliminated in the urine as a glucuronide. Dexmedetomidine is a substrate and inhibitor of cytochrome oxidase 2D6, but clinical evidence of significant drug interactions is lacking. Clinical trials suggest efficacy for the treatment of delirium in the intensive care unit setting with efficacy comparable to haloperidol and benzodiazepines. Dexmedetomidine also has an opioid-sparing action and can act to enhance analgesia. The purpose of this article is to review the pharmacodynamics and pharmacology of dexmedetomidine, and examine its potential use in the palliative care population, especially with regard to the management of delirium.
右美托咪定是一种α（2）肾上腺素能激动剂，已获美国食品药品监督管理局批准用于镇静和镇痛。作为一种高效的α（2）肾上腺素能激动剂，它起效迅速，给药后1小时内达到峰值效应。它在肝脏中代谢，并以葡萄糖醛酸苷的形式经尿液排出。右美托咪定是细胞色素氧化酶2D6的底物和抑制剂，但缺乏显著药物相互作用的临床证据。临床试验表明，在重症监护病房环境中，右美托咪定治疗谵妄有效，疗效与氟哌啶醇和苯二氮䓬类药物相当。右美托咪定还具有节省阿片类药物的作用，并可增强镇痛效果。本文旨在综述右美托咪定的药效学和药理学，并探讨其在姑息治疗人群中的潜在用途，尤其是在谵妄管理方面。
