Precedex - page 2

by Stlcardsrock

6,218 Views | 13 Comments

We were just courted by the Precedex guy from Abbott recently and a lot of us haven't used Precedex before. We are an all encompassing unit here including open heart recovery. Could I get some help on dosages, indicators for... Read More


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    Our CVICU has had pretty poor results with Precedex alone. If we run it with low dose Propofol it works pretty well. Most of our physicians do not prefer to use it. We are an academic university with > 800 beds. Most of the uncomplicated heart surgery patients are extubated within a six hour window of time. The aortic valve/aneurysms have been tried on Precedex and do not do well--still have pump head most of the time. We had someone on 1.7 mcg/kg/hr who still had 5 nurses holding him down until Propofol could be given.
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    I heard its more expensive than propofol but was useful during
    the recent propofol shortage. Its supposed to cause less icu
    delirium. But when we tried to use it on our unit it didn't
    work so well, the pts were still agitated trying to self extubate.

    I did read somewhere if you add a lose dose fentanyl gtt
    that it is more effective in decreasing agitation. Anyone else?
  3. 0
    Quote from tahoe77
    I heard its more expensive than propofol but was useful during
    the recent propofol shortage. Its supposed to cause less icu
    delirium. But when we tried to use it on our unit it didn't
    work so well, the pts were still agitated trying to self extubate.

    I did read somewhere if you add a lose dose fentanyl gtt
    that it is more effective in decreasing agitation. Anyone else?
    It's useful if it's started in surgery and used as a bridge to extubation, its usually not started correctly. The patient needs to be kept in a dim quiet room without a lot of stimulation and usually helps if they're on a benzo and/or narcotic because it's potentiates the effects. I think it's only FDA approved for 24 hours but some docs will use it for days and days...
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    We don't use Precedex at all for our hearts. My experience with Precdex isn't great b/c it doesn't work all the time & it does cause hypotension & bradycardia.

    It's for short term intubations & easy neruo checks, but it doesn't work for every patient.

    We've used it for 2 yrs now & I'm not a fan of it, it usually causes me more work for fix the side effects for such an expensive drug.

    go to the main website http://www.precedex.com/ it should explain dose there.

    This is a medication of mcg/kg/hr & I agree bolus of medication does cause issues with hypotention & I usually give it in 10 mins but stop it before then & just start the maintenance rate.


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