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Drug Dev Ind Pharm. 2016 Dec;42(12):1917-1927. Epub 2016 Sep 21.

Pharmacokinetics and pharmacodynamics of dexmedetomidine.

Author information

1
a Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine , The University of Hong Kong , Pokfulam , Hong Kong SAR , China ;
2
b Department of Anesthesiology , University of Hong Kong Shenzhen Hospital , Futian , Guangdong , Shenzhen , China ;
3
c Département Laboratoires, AGEPS , Assistance Publique des Hôpitaux de Paris , Paris , France.

Abstract

Dexmedetomidine is an alpha-2 adrenoceptor agonist and has been used as a general anesthetic, sedative and analgesic for about 30 years. The aim of this paper is to review the pharmacokinetics and pharmacodynamics of dexmedetomidine, evaluate physiological factors that may affect the pharmacokinetics of dexmedetomidine, and summarize the pharmacodynamics of dexmedetomidine at different plasma levels. The pharmacokinetic parameters reported in previous studies according to noncompartmental analyses or population modeling results are compared. We concluded that the pharmacokinetic profile can be adequately described by a two-compartment model in population pharmacokinetic modeling. Body weight, height, albumin level, cardiac output, disease condition and other factors were considered to have significant influence on the clearance and/or distribution volume in different population pharmacokinetic models. The pharmacological effects of dexmedetomidine, such as sedation, heart rate reduction and biphasic change of blood pressure, vary at different plasma levels. These findings provide a reference for individualizing the dose of dexmedetomidine and achieving the desired pharmacological effects in clinical applications.

KEYWORDS:

Dexmedetomidine; analgesia; anesthesia; perioperation; pharmacodynamics; pharmacokinetics; premedication; sedation

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