Evaluation of the clinical efficacy and safety of intramuscular and intravenous doses of dexmedetomidine and medetomidine in dogs and their reversal with atipamezole

Granholm, Mikael; McKusick, Brett C; Westerholm, Fia C; Aspegrén, John

doi:10.1136/vr.160.26.891

Cited by 88 publications

(84 citation statements)

References 5 publications

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“…PR after dexmedetomidine–midazolam injection decreased over time, as expected of the effects of α-2 agonist (Zornow 1991, Blake 2000, Granholm and others 2007), but it was maintained at a similar level to the values measured in conscious rabbits in the ketamine group. No differences over time were observed between the groups, probably as a result of the low doses of dexmedetomidine used in this study, which minimally affected heart rate.…”

Section: Discussionsupporting

confidence: 62%

“…In both sedative protocols, DoBP was above 80 mm Hg, although dexmedetomidine appeared to maintain blood pressure at higher values than in the ketamine group. Peripheral vasoconstriction associated with α-2 agonist administration may explain this observation (Blake 2000, Granholm and others 2007). …”

Section: Discussionmentioning

confidence: 99%

“…Dexmedetomidine, the pharmacological active isomer of medetomidine, is licensed for dogs and cats; the onset of sedation and analgesia is faster when administered intramuscularly compared with the racemate drug (Granholm and others 2007). Dexmedetomidine causes a dose-dependent decrease in heart rate and blood pressure and mild respiratory depression in rabbits (Zornow 1991, Blake 2000, Nishida and others 2002).…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of sedation and clinical effects of midazolam with ketamine or dexmedetomidine in pet rabbits

et al. 2014

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The effects of two sedation protocols combining midazolam with ketamine (ketamine group) or dexmedetomidine (dexmedetomidine group) were studied in dwarf companion rabbits undergoing abdominal ultrasound scan. The onset of sedation was faster in the ketamine group; a few rabbits in the dexmedetomidine group required additional doses to lose the righting reflex, although sedation time was not different between groups. A semi-quantitative scale was used to score sedation quality, which was higher in rabbits that received dexmedetomidine rather than ketamine. Pulse rate was lower in the dexmedetomidine group (206 vs 240 bpm), although Doppler blood pressure was higher than in the ketamine group (109 vs 89 mm Hg). Respiratory rate decreased in relation to the baseline values with both protocols but arterial haemoglobin saturation with oxygen was maintained similar to the pre-sedation values throughout the entire procedure, regardless of protocol used and without oxygen supplementation. Both protocols allowed performance of ultrasound scanning, although dexmedetomidine may be preferred if a deep sedation level is required.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of sedation and clinical effects of midazolam with ketamine or dexmedetomidine in pet rabbits

et al. 2014

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“…The low alpha 1 adrenoceptor affinity of DEX avoids arrhythmias mediated by catecholamines. Moreover, the dose of DEX to metabolize is administered at half the corresponding S214 Vet Res Commun (2009) 33 (Suppl 1):S213-S215 bioequivalent dose of MED (Kuusela et al 2000;Granholm et al 2006Granholm et al , 2007. Low doses of LEV produce anti-sedative and anti-analgesic effects (Kuusela et al 2001).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the muscular relaxant effect of dexmedetomidine or medetomidine in cats

et al. 2009

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The alpha2 adrenoceptor agonist medetomidine (MED) is an equal racemic mixture of two enantiomers, dexmedetomidine (DEX) and levomedetomidine (LEV); the LEV enantiomer is generally considered to be pharmacologically inactive, whereas the DEX enantiomer is active (Virtanen et al., 1988; MacDonald et al., 1991; Savola et al., 1991). Clinical studies in dogs and cats have shown that the pharmacodynamic effects of DEX are twice as potent as MED racemic mixture, therefore DEX administered at half the dose compared with MED for sedation; such as MED, DEX sedative and analgesic effects are antagonised by atipamezole (Cullen et al., 1996; Ansah et al., 1998; Kuusela et al., 2000; Ansah et al., 2000; Mendes et al., 2003; Granholm et al., 2006). DEX has been approved in Italy for clinical use in dogs and cats since 2008, and immediately we started to use it for dog and cat sedation. The DEX sedation effect in the dog is looked like MED, whereas the muscular relaxant effect in the cat was lower than MED. The aim of this study was to evaluate and compare the muscular relaxant effects in cats following DEX or MED used at bioequivalent dose

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“…Ses effets en surdosage sur l'homme sont peu décrits, avec principalement une atteinte cardio-vasculaire (hypotension artérielle et bradycardie), et neurologique (séda-tion). Cette molécule n'affecte pas significativement le système respiratoire humain [3]. Il existe très peu de publications décrivant des cas d'intoxication par dexmédétomidine : aucune observation d'intoxication volontaire et seulement un article rapportant trois cas de surdosage accidentel.…”

Section: Discussionunclassified

Une observation de suicide d’un vétérinaire par pentobarbital et dexmédétomidine

et al. 2012

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Résumé -Introduction : Il existe dans la littérature médicale peu de références rapportant des observations d'intoxication volontaire humaine par euthanasiants pour animaux. Les auteurs présentent le cas d'un vétérinaire de 38 ans qui s'est injecté, pour se suicider, deux euthanasiants pour animaux utilisés dans sa pratique courante. Méthode : Il s'agit d'une observation du centre antipoison de Marseille qui a été consulté pour une aide à la prise en charge de cette intoxication inhabituelle. Résultat : Le patient s'est administré du pentobarbital, barbiturique qui n'est plus utilisé en médecine humaine en France et de la dexmédétomidine, un agoniste sélectif des récepteurs α2-adrénergiques aux propriétés hypnotiques et analgésiques. Lorsqu'elle l'a découvert, la famille, travaillant également dans le domaine vé-térinaire, lui a aussitôt administré l'antidote de la dexmédétomidine et contacté les urgences. L'équipe médicale arrivée sur place a trouvé le patient en arrêt cardio-respiratoire, avec un score de Glasgow à 3. Malgré une prise en charge en service spécialisé, le patient décédera au bout de 13 jours des complications anoxiques de son arrêt respiratoire. Discussion : Le rôle du pentobarbital et de la dexmédétomidine dans la symptomatologie du patient, ainsi que l'influence de l'administration de l'antidote sont discutés dans cet article. Conclusion : Il paraît important que les professionnels de santé soient informés de l'existence de ces produits vétérinaires et de leurs propriétés pharmacologiques afin de prendre en charge au mieux les patients potentiellement intoxiqués avec ces molécules.Mots clés : Dexmédétomidine, pentobarbital, atipamézole, suicide, vétérinaire Abstract -Introduction: Suicide poisonings with drugs used for animal euthanasia are rare in the medical literature. The authors describe the case of a 38-year-old veterinary surgeon who killed himself in his office with intravenous injection of two molecules: dexmedetomidine and pentobarbital. Method: Description of a clinical observation of the Marseille Poison Control Centre. Results: The two veterinary drugs used by the patient were high quantities of pentobarbital, which is a barbiturate no longer used in France as a human medicine, and dexmedetomidine, which is an α2 agonist used in veterinary medicine for its hypnotic and analgesic properties. As soon as the family (also working as veterinary practitioners) discovered the poisoned patient, the antidote of dexmedetomidine was injected, and the emergency medical team that arrived found the patient to have respiratory arrest with a Glasgow coma scale of 3. Despite being taken to an intensive care unit he died from complications of respiratory arrest 13 days after the overdose. Discussion: The role of each of the molecules (pentobarbital and dexmedetomidine) in the development of the clinical features and the influence of the administration of the antidote are discussed in this paper. Conclusion: It seems important to inform medical practitioners and clinical toxicologists about these ve...

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Evaluation of the clinical efficacy and safety of intramuscular and intravenous doses of dexmedetomidine and medetomidine in dogs and their reversal with atipamezole

Cited by 88 publications

References 5 publications

Evaluation of sedation and clinical effects of midazolam with ketamine or dexmedetomidine in pet rabbits

Evaluation of sedation and clinical effects of midazolam with ketamine or dexmedetomidine in pet rabbits

Evaluation of the muscular relaxant effect of dexmedetomidine or medetomidine in cats

Une observation de suicide d’un vétérinaire par pentobarbital et dexmédétomidine

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