title: Two cases of acute dexmedetomidine withdrawal syndrome following prolonged infusion in the intensive care unit: Report of cases and review of the literature.
abstract: Prolonged infusion of dexmedetomidine, an α(2)-adrenoreceptor agonist anesthetic used in the intensive care unit, produces a withdrawal syndrome of sympathetic over-activity, characterized by tachycardia, hypertension and agitation, but there is no recommended standard treatment for this syndrome. We describe two patients with a clinical diagnosis of acute dexmedetomidine withdrawal and its management with oral clonidine. We utilized the principle of managing acute drug withdrawal with longer acting medications. These two cases demonstrated the benefit of using oral, longer acting clonidine to manage acute withdrawal from shorter-acting, intravenous dexmedetomidine.
authors.affiliation: Department of Anesthesiology, Johns Hopkins Hospital, Baltimore, MD, USA.
authors.forename: At
authors.initials: A
authors.lastname: Kukoyi
authors.forename: Sa
authors.initials: S
authors.lastname: Coker
authors.forename: Ld
authors.initials: L
authors.lastname: Lewis
authors.forename: Dw
authors.initials: D
authors.lastname: Nierenberg
mesh_terms: D003000:Clonidine / Q000627:therapeutic use; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous; D007362:Intensive Care Units; D008875:Middle Aged; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000209:etiology*; D013565:Sympatholytics / Q000627:therapeutic use
chemical_list: D006993:Hypnotics and Sedatives; D013565:Sympatholytics; D020927:Dexmedetomidine; D003000:Clonidine