Dexmedetomidine (Precedex)
	Standard dilution: Precedex 200mcg (2ml) diluted in 48ml normal saline
	Loading dose: _____ mcg/kg over 20 minutes (normal renal function: 1mcg/kg)
		*** A LOADING DOSE IS NOT REQUIRED FOR ALL PATIENTS ***
	Loading infusion
	Patient weight (kg)		50	60	70	80	90	100	110	120	130	140	150
	Total dose delivered		50	60	70	80	90	100	110	120	130	140	150
	Loading infusion rate		37.5	45	52.5	60	67.5	75	82.5	90	97.5	105	112.5
	Note: Loading dose may cause transient hypertension
	Maintenance dose: _____ mcg/kg/hr (usual range: 0.2-0.7mcg/kg/hr). Titrate for effect in
	increments of 0.1mcg/kg/hr every 15 minutes
	Keep HR > _____  SBP > _____  MAP > _____
	Maintenance infusion (4mcg/ml final concentration)
	Patient weight (kg)		50	60	70	80	90	100	110	120	130	140	150
	0.2mcg/kg/hr		2.5	3.0	3.5	4.0	4.5	5.0	5.5	6.0	6.5	7.0	7.5
	0.3mcg/kg/hr		3.8	4.5	5.3	6.0	6.8	7.5	8.3	9.0	9.8	10.5	11.3
	0.4mcg/kg/hr		5.0	6.0	7.0	8.0	9.0	10.0	11.0	12.0	13.0	14.0	15.0
	0.5mcg/kg/hr		6.3	7.5	8.8	10.0	11.3	12.5	13.8	15.0	16.3	17.5	18.8
	0.6mcg/kg/hr		7.5	9.0	10.5	12.0	13.5	15.0	16.5	18.0	19.5	21.0	22.5
	0.7mcg/kg/hr		8.8	10.5	12.3	14.0	15.8	17.5	19.3	21.0	22.8	24.5	26.3
	Titrate to Ramsay Scale score of _____
	Ramsay Sedation Scale
	Score	Observation
	1	Anxious, agitated, or restless
	2	Cooperative, oriented, and tranquil
	3	Responsive to commands
	4	Asleep, but with brisk response to light glabellar tap or loud auditory stimulus
	5	Asleep, sluggish response to glabellar tap or auditory stimulus
	6	Asleep, no response
	Notify MD if:
	SBP < 90, CVP < 14: place patient in Trendelenburg and administer ___________________
	Persistent hypotension: reduce Precedex infusion by 50%
	SBP and MAP do not return to parameters specified in 10 minutes: discontinue Precedex
	HR < 45 or if patient develops 2nd or 3rd degree heart block: discontinue Precedex
		For HR < 45, administer atropine 0.2mg IV
	Patient may remain on Precedex before, during, and after extubation
	Maximum recommended infusion time is 24 hours
	Dosage reductions may be necessary in patients with renal/hepatic dysfunction and elderly
	Precedex augments analgesic effects of opioids.  Reduced dose is recommended for
		supplemental narcotic of benzodiazepine administration
	Precedex is compatibile with LR, D5W, NS, 20% mannitol, thiopental, etomidate, vecuronium,
		pancuronium, succinylcholine, atracurium, glycopyrrolate, phenylephrine, atropine,
		midazolam, morphine, and fentanyl
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