Changing to a Better Sedative / Analgesic: The Alpha-2 Agonist Dexmedetomidine
The alpha-2 adrenoceptor agonist drugs have analgesic and sedative/hypnotic actions, profoundly useful in most of our patients. Higher doses have utility for procedural sedation with analgesia. Lower doses are increasingly used for sedation and to manage stress responses in many patient populations, including higher risk patients.
Clinically, the greater selectivity for alpha-2 receptors that is associated with dexmedetomidine, as opposed to xylaxine, results in a more useful drug. Dexmedetomidine also provides more control as there are different dosages for different procedures, each providing a specific level of sedation and analgesia. It is important to note that in dogs, the mcg/kg dose increases as an animals body weight decreases. Because dexmedetomidine is reversible with atipamezole, it also allow dogs to recovery more quickly (with care and if needed) from sedation. The richly expanded off-label applications have been strongly influenced by the accumulation of additional evidence and years of extensive clinical experience.
Recording from 22.05.2018
Dr Ralph Harvey, DVM, MS, Diplomate ACVAA
Dr. Ralph Harvey teaches anesthesia and pain management in the Department of Small Animal Clinical Sciences at the University of Tennessee College of Veterinary Medicine in Knoxville, Tennessee. He previously served as the Section Head for the Small Animal Surgical Services and as a member of the University Faculty Senate. His veterinary degree is from the UTCVM and his post-graduate training included internship, residency, and fellowship at Cornell's Veterinary and Medical Colleges.
Dr. Harvey has worked in private small animal practice. He is certified as a specialist by the American College of Veterinary Anesthesia and Analgesia, has served as their Executive Secretary and as a member of the ACVAA Board of Directors. He is currently a member of the Fear-Free Advisory Panel and the Fear Free Executive Council.
He has received the UTCVM Brandy Memorial Award, the Outstanding Faculty Member Award from the Tennessee Veterinary Medical Association, and the UTCVM Outstanding Alumni Non-Practice Career Award.
His community service has included work with regional science fair programs, Explorer Scouting, the Leukemia/Lymphoma Society, and with wilderness and conservation groups.