• To induce sedation in adult patients within the Intensive Care Unit (ICU), aiming for a sedation level no more profound than responding to verbal stimuli, as indicated by the Richmond Agitation-Sedation Scale (RASS) within the range of 0 to -3.
• To achieve sedation in adult patients who are not intubated before and/or during diagnostic or surgical procedures that necessitate a sedated state, specifically known as procedural or awake sedation.

Patients already intubated and sedated may switch to dexmedetomidine with an initial infusion rate of 0.7 micrograms/kg/h which may then be adjusted stepwise within the dose range of 0.2 to 1.4 micrograms/kg/h in order to achieve the desired level of sedation, depending on the patient's response. A lower starting infusion rate should be considered for frail patients. Dexmedetomidine is very potent and the infusion rate is given per hour. After dose adjustment, a new steady state sedation level may not be reached for up to one hour.

Adverse reactions of Dexmedetomidine are listed below-

• Hypotension
• Bradycardia
• Dry mouth
• Nausea

Hypotension (Low Blood Pressure)

Bradycardia

Dry Mouth

Nausea

Hypotension and Bradycardia:

• Continuous monitoring of blood pressure and heart rate is essential during dexmedetomidine infusion.
• Dose adjustment or discontinuation may be necessary if severe hypotension or bradycardia occurs.

Respiratory Depression:

• Dexmedetomidine can cause respiratory depression, particularly when co-administered with other sedatives or opioids.
• Continuous monitoring of respiratory function is crucial.

Use in Elderly Patients:

• Elderly patients may be more susceptible to the hypotensive effects of dexmedetomidine.
• Careful titration and monitoring are recommended in this population.

Rebound Hypertension and Tachycardia:

• Abrupt discontinuation of dexmedetomidine may lead to rebound hypertension and tachycardia.
• Consider tapering the infusion rate gradually.