Hypoglycemia associated with dexmedetomidine overdose in a child?

Bernard, Philip; Makin, Carrie; Werner, H.

doi:10.1016/j.jclinane.2008.06.025

Cited by 11 publications

(7 citation statements)

References 16 publications

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“…The patient developed hypertension to 135/75 mmHg and prolonged sedation of over 4 h. There was no notable respiratory depression. The second case report describes a 20-month-old girl who received 1 µg/kg/min for 36 min during cardiac catheterization [81]. This patient experienced a decrease in heart rate with a nadir of 84 beats/min 1.5 h following end of infusion compared to baseline of 126 beats/min.…”

Section: Overdosementioning

confidence: 99%

Dexmedetomidine: pediatric pharmacology, clinical uses and safety

Hammer

2010

Expert Opinion on Drug Safety

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Section: Overdosementioning

confidence: 99%

Dexmedetomidine: pediatric pharmacology, clinical uses and safety

Hammer

2010

Expert Opinion on Drug Safety

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“…Furthermore, an overdose of dexmedetomidine might inhibit β-adrenergic stimulation leading to hypoglycaemia. [10] In the case described here, blood glucose levels remained normal. This may be ascribed to the adrenaline infusion.…”

Section: Discussionmentioning

confidence: 72%

“…[10] The cause of hypoglycaemia was ascribed to decrease in circulating norepinephrine. Furthermore, an overdose of dexmedetomidine might inhibit β-adrenergic stimulation leading to hypoglycaemia.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine overdosage: An unusual presentation

2013

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We present a case of dexmedetomidine toxicity in a 3-year-old child. The case report describes the features and outlines the treatment strategy adopted. The child presented with bradypnoea, bradycardia, hypotension, deep hypnosis and miosis. He was successfully managed with oxygen, saline boluses and adrenaline infusion. He became haemodynamically stable with adrenaline infusion. He started responding to painful stimuli in 3 h and became oriented in 7 h. Dexmedetomidine, a selective α2 adrenoceptor agonist, is claimed to have a wide safety margin. This case report highlights the fact that dexmedetomidine administered in a toxic dose may be life-threatening may present with miosis and adrenaline infusion may be a useful supportive treatment.

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“…Unique among sedatives, it causes minimal respiratory depression, even at higher levels. 15 Bradycardia and hypotension are the most frequently reported adverse effects of dexmedetomidine, yet are infrequently clinically significant. 16 Pediatric dosing of dexmedetomidine continues to be refined, including use of loading doses.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment of ifosfamide neurotoxicity with dexmedetomidine

Bernard

McCabe

Bayliff

et al. 2010

J Oncol Pharm Pract

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Neurotoxicity related to the use of ifosfamide is a well-known complication. While the use of methylene blue is a known antidote, symptomatic treatment of the central nervous system (CNS) effects can be challenging. We present a case of class IV neurotoxicity with the successful treatment of symptomology. In this case report we present a 2-year-old female with relapsed alveolar rhabdomyosarcoma undergoing palliative chemotherapy. Patient received ifosfamide in addition to etoposide and mesna. The patient developed acute hallucinations, agitation, and delirium. The patient was transferred to the pediatric intensive care unit where she was administered dexmedetomidine overnight in addition to methylene blue. The patient awoke the next morning following discontinuation of the dexmedetomidine infustion and subsequently had no further central nervous system effects. This case demonstrates the novel use of an alpha-2 agonist in the treatment of neurotoxicity related to ifosfamide administration.

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Hypoglycemia associated with dexmedetomidine overdose in a child?

Cited by 11 publications

References 16 publications

Dexmedetomidine: pediatric pharmacology, clinical uses and safety

Dexmedetomidine: pediatric pharmacology, clinical uses and safety

Dexmedetomidine overdosage: An unusual presentation

Successful treatment of ifosfamide neurotoxicity with dexmedetomidine

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