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Medetomidine
Systematic (IUPAC) name
(RS)-4-[1-(2,3-dimethylphenyl)ethyl]-3H-imidazole
Identifiers
CAS number 86347-14-0
ATCvet code QN05CM91
PubChem 68602
Chemical data
Formula C13H16N2 
Mol. mass 200.279 g/mol
Therapeutic considerations
Pregnancy cat.  ?
Legal status Veterinary use only

Medetomidine (active form medetomidine hydrochloride) is a synthetic drug used as both a surgical anesthetic and analgesic. It is a crystalline white alpha-two adrenergic agonist[1] that can be administered as an intravenous drug solution with sterile water. It is currently approved for dogs in the United States, and distributed in the United States by Pfizer Animal Health and by Novartis Animal Health in Canada under the product name Domitor. Other alpha-two agonists used in veterinary medicine include Xylazine and Detomidine, their use is less common in small animal surgery. The marketed product; domitor, is actually a racemic mixture of 2 stereoisomers, dexmedetomidine is the compound with more useful effects, and is now marketed as Dexdomitor.

Contents

Uses

It is often used in combinations with opioids (butorphanol, buprenorphine etc) as premedication (before a general anaesthetic) in healthy cats and dogs. It can be given by intramuscular injection (IM), subcutaneous injection (SC) or intravenous injection (IV). When delivered intravenously, a significantly decreased dose is used. Some authors suggest a sublingual route is also effective. It is not recommended for diabetics, it is contraindicated in patients with cardiac disease. Due to its potent sedative effects it is commonly used in more aggressive animals, where a drug/combination with a lesser effect (i.e. Acetylpromazine + an Opioid, an Opioid + a Benzodiapezine) would not allow the administration of the inductive agent without risk to the veterinarian. As such the use of alpha-two agonists is only recommended in healthy animals.

Following administration, marked peripheral vasoconstriction and bradycardia are noted. Often the dosage of induction agents (i.e. propofol) may be drastically reduced, as may the volumes of anaesthetic gases (i.e. halothane, isoflurane, sevoflurane) used to maintain general anaesthesia.

It is sometimes used in combination with butorphanol and ketamine (given IM) to produce general anaesthesia for short periods in healthy but fractious felines that will not allow an intravenous induction agent to be given. It provides a good degree of muscle relaxation, an important factor in Ketamine based anaethesia protocols.

Medetomidine has also been used in combination with morphine (or methadone), lignocaine and ketamine in constant rate infusion analgesia in canines. It is often used in so called microdoses for this analgesic effect.

It is thought that this family of drugs has a degree of analgesic action, though this is, in comparison to the sedative effect, minor.

Reversal of effects

Its effects can be reversed using atipamezole (distributed as Antisedan by Pfizer). IV use of Atipamezole is not licensed, IM is the preferred route. Yohimbine may also be used in an emergency situation, but is not licensed.

See also

References

  1. ^ Sinclair MD (November 2003). "A review of the physiological effects of alpha2-agonists related to the clinical use of medetomidine in small animal practice". Can. Vet. J. 44 (11): 885–97. PMID 14664351. 
  • Novartis Animal Health Canada[1]. 2003.


Harari, J. Small Animal Surgery. Williams and Wilkins, Media, PA. 1996.








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