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Severe Rash Associated with Dexmedetomidine Use During Mechanical Ventilation
Author(s) -
Ludwig Kyle,
Sorrell Matthew,
Liu Peter
Publication year - 2009
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.29.4.479
Subject(s) - dexmedetomidine , medicine , rash , anesthesia , propofol , sedation , mechanical ventilation , adverse effect , fentanyl , bradycardia , sedative , discontinuation , surgery , heart rate , blood pressure
Dexmedetomidine, a sedative administered by continuous infusion, is used to facilitate mechanical ventilation through α 2 ‐receptor activation. The drug's most common adverse reactions include hypotension, hypertension, nausea, bradycardia, and dry mouth. However, to our knowledge, no reports of dermatologic allergic reactions from dexmedetomidine use have been published. We describe a 22‐year‐old man who was intubated after being injured in a motor vehicle collision. He had been receiving propofol and fentanyl infusions for sedation during mechanical ventilation and was transitioning to dexmedetomidine. Within 4 hours of receiving dexmedetomidine 0.2 μg/kg/hour, the patient developed a wheal‐and‐flare rash encompassing 60% of his body surface area. The infusion was immediately discontinued; over the next 24 hours most of the rash receded, and within 48 hours of drug discontinuation the rash had completely resolved. According to the Naranjo adverse drug reaction probability scale, the likelihood that this rash was induced by dexmedetomidine was probable. Clinicians should be aware of this potential dermatologic adverse effect from dexmedetomidine, and patients receiving the drug should be closely monitored.