{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T01:47:42Z","timestamp":1783734462402,"version":"3.55.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Dexmedetomidine is a central \u03b12 agonist commonly used on intubated patients. It is increasingly being used off-label in nonintubated agitated patients. We sought to determine the overall clinical course, adverse effects, and need for subsequent mechanical ventilation in toxicology patients after treatment with dexmedetomidine.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a retrospective cohort study conducted by chart review of electronic records from the Virginia Poison Control Center from January 1, 2019 to February 4, 2022. Inclusion criteria consisted of all poison center cases where dexmedetomidine was used. The primary outcome was the presence or absence of clinical improvement following dexmedetomidine use. Secondary outcomes included adverse effects, subsequent intubation, or death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During this study period, there were 220 cases in which dexmedetomidine was used to treat agitation. After exclusions, 70 cases were analyzed. The categories included antimuscarinic (n = 19), polysubstance (n = 16), sedative withdrawal (n = 10), unknown agitation (n = 7), sympathomimetic (n = 5), baclofen withdrawal (n = 3), unknown ingestion (n = 3), sedative\/hypnotic (n = 2), antipsychotic (n = 2), hallucinogenic (n = 2), and opioid withdrawal (n = 1). Clinical improvement occurred in 62 of 70 patients (89%). There were no deaths. A total of 4 patients were intubated after starting dexmedetomidine, 2 for refractory agitation and 2 for hypoxia after aspiration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Global clinical improvement was observed in the agitated toxicology patients administered dexmedetomidine. There was one case of intubation secondary to oversedation. Dexmedetomidine could be a useful adjunctive treatment for agitated toxicologic patients but should be studied further before routinely used.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ajhp\/zxac378","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T10:26:48Z","timestamp":1671704808000},"page":"526-531","source":"Crossref","is-referenced-by-count":2,"title":["Clinical characteristics and outcomes using dexmedetomidine in nonintubated patients: A poison center observational study"],"prefix":"10.1093","volume":"80","author":[{"given":"Emily","family":"Kershner","sequence":"first","affiliation":[{"name":"Virginia Poison Center, Division of Clinical Toxicology and Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Tobarran","sequence":"additional","affiliation":[{"name":"Virginia Poison Center, Division of Clinical Toxicology and Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Chambers","sequence":"additional","affiliation":[{"name":"Virginia Poison Center, Division of Clinical Toxicology and Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zach","family":"Jenkins","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon K","family":"Wills","sequence":"additional","affiliation":[{"name":"Virginia Poison Center, Division of Clinical Toxicology; and Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirk L","family":"Cumpston","sequence":"additional","affiliation":[{"name":"Virginia Poison Center, Division of Clinical Toxicology; and Department of Emergency Medicine, Virginia Commonwealth University Health System , Richmond, VA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"issue":"2","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1097\/00000542-200008000-00016","article-title":"The effects of increasing plasma concentrations of dexmedetomidine in humans","volume":"93","author":"Ebert","year":"2000","journal-title":"Anesthesiology"},{"issue":"9","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1164\/rccm.201710-1995OC","article-title":"Low-dose nocturnal dexmedetomidine prevents ICU delirium. a randomized, placebo-controlled trial","volume":"197","author":"Skrobik","year":"2018","journal-title":"Am J Respir Crit Care Med"},{"issue":"6","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1016\/j.chest.2020.12.052","article-title":"Safety and efficacy of dexmedetomidine in acutely ill adults requiring noninvasive ventilation: a systematic review and meta-analysis of randomized trials","volume":"159","author":"Lewis","year":"2021","journal-title":"Chest"},{"issue":"5","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"525","DOI":"10.3109\/15563650.2014.913175","article-title":"Evaluation of dexmedetomidine therapy for sedation in patients with toxicological events at an academic medical center","volume":"52","author":"Mohorn","year":"2014","journal-title":"Clin Toxicol"},{"issue":"1","key":"2023040806190408500_","first-page":"43","article-title":"Dexmedetomidine to control agitation and delirium from toxic ingestions in adolescents","volume":"15","author":"Tobias","year":"2010","journal-title":"J Pediatr Pharmacol Ther"},{"issue":"4","key":"2023040806190408500_","first-page":"329","article-title":"Dexmedetomidine infusion to control agitation due to antimuscarinic toxidromes in adolescents, a case series","volume":"20","author":"Gee","year":"2015","journal-title":"J Pediatr Pharmacol Ther"},{"issue":"5","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1097\/CCM.0000000000000141","article-title":"A randomized, double-blind, placebo-controlled dose range study of dexmedetomidine as adjunctive therapy for alcohol withdrawal","volume":"42","author":"Mueller","year":"2014","journal-title":"Crit Care Med"},{"key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1007\/s00540-012-1381-y","article-title":"Use of dexmedetomidine for the treatment of alcohol withdrawal syndrome in critically ill patients: a retrospective case series","volume":"26","author":"DeMuro","year":"2012","journal-title":"J Anesth"},{"issue":"2","key":"2023040806190408500_","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1002\/jhm.282","article-title":"Use of dexmedetomidine for sedation of children hospitalized in the intensive care unit","volume":"3","author":"Carroll","year":"2008","journal-title":"J Hosp Med"},{"key":"2023040806190408500_","first-page":"1502","article-title":"The effect of dexmedetomidine on outcomes of cardiac surgery in elderly patients. 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