Skip to main content
Erschienen in: Clinical Autonomic Research 4/2017

03.07.2017 | Short Communication

Intranasal dexmedetomidine for adrenergic crisis in familial dysautonomia

verfasst von: Christy L. Spalink, Erin Barnes, Jose-Alberto Palma, Lucy Norcliffe-Kaufmann, Horacio Kaufmann

Erschienen in: Clinical Autonomic Research | Ausgabe 4/2017

Einloggen, um Zugang zu erhalten

Abstract

Purpose

To report the use of intranasal dexmedetomidine, an α2-adrenergic agonist for the acute treatment of refractory adrenergic crisis in patients with familial dysautonomia.

Methods

Case series.

Results

Three patients with genetically confirmed familial dysautonomia (case 1: 20-year-old male; case 2: 43-year-old male; case 3: 26-year-old female) received intranasal dexmedetomidine 2 mcg/kg, half of the dose in each nostril, for the acute treatment of adrenergic crisis. Within 8–17 min of administering the intranasal dose, the adrenergic crisis symptoms abated, and blood pressure and heart rate returned to pre-crises values. Adrenergic crises eventually resumed, and all three patients required hospitalization for investigation of the cause of the crises.

Conclusions

Intranasal dexmedetomidine is a feasible and safe acute treatment for adrenergic crisis in patients with familial dysautonomia. Further controlled studies are required to confirm the safety and efficacy in this population.
Literatur
1.
Zurück zum Zitat Belleville JP, Ward DS, Bloor BC, Maze M (1992) Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. Anesthesiology 77:1125–1133CrossRefPubMed Belleville JP, Ward DS, Bloor BC, Maze M (1992) Effects of intravenous dexmedetomidine in humans. I. Sedation, ventilation, and metabolic rate. Anesthesiology 77:1125–1133CrossRefPubMed
2.
Zurück zum Zitat Dillon RC, Palma JA, Spalink CL, Altshuler D, Norcliffe-Kaufmann L, Fridman D, Papadopoulos J, Kaufmann H (2017) Dexmedetomidine for refractory adrenergic crisis in familial dysautonomia. Clin Auton Res Off J Clin Auton Res Soc 27:7–15CrossRef Dillon RC, Palma JA, Spalink CL, Altshuler D, Norcliffe-Kaufmann L, Fridman D, Papadopoulos J, Kaufmann H (2017) Dexmedetomidine for refractory adrenergic crisis in familial dysautonomia. Clin Auton Res Off J Clin Auton Res Soc 27:7–15CrossRef
3.
Zurück zum Zitat Iirola T, Vilo S, Manner T, Aantaa R, Lahtinen M, Scheinin M, Olkkola KT (2011) Bioavailability of dexmedetomidine after intranasal administration. Eur J Clin Pharmacol 67:825–831CrossRefPubMed Iirola T, Vilo S, Manner T, Aantaa R, Lahtinen M, Scheinin M, Olkkola KT (2011) Bioavailability of dexmedetomidine after intranasal administration. Eur J Clin Pharmacol 67:825–831CrossRefPubMed
4.
Zurück zum Zitat Norcliffe-Kaufmann L, Martinez J, Axelrod F, Kaufmann H (2013) Hyperdopaminergic crises in familial dysautonomia: a randomized trial of carbidopa. Neurology 80:1611–1617CrossRefPubMedPubMedCentral Norcliffe-Kaufmann L, Martinez J, Axelrod F, Kaufmann H (2013) Hyperdopaminergic crises in familial dysautonomia: a randomized trial of carbidopa. Neurology 80:1611–1617CrossRefPubMedPubMedCentral
5.
Zurück zum Zitat Norcliffe-Kaufmann L, Palma JA, Kaufmann H (2016) Mother-induced hypertension in familial dysautonomia. Clin Auton Res Off J Clin Auton Res Soc 26:79–81CrossRef Norcliffe-Kaufmann L, Palma JA, Kaufmann H (2016) Mother-induced hypertension in familial dysautonomia. Clin Auton Res Off J Clin Auton Res Soc 26:79–81CrossRef
6.
Zurück zum Zitat Norcliffe-Kaufmann L, Slaugenhaupt SA, Kaufmann H (2017) Familial dysautonomia: history, genotype, phenotype and translational research. Prog Neurobiol 152:131–148CrossRefPubMed Norcliffe-Kaufmann L, Slaugenhaupt SA, Kaufmann H (2017) Familial dysautonomia: history, genotype, phenotype and translational research. Prog Neurobiol 152:131–148CrossRefPubMed
7.
Zurück zum Zitat Palma JA, Norcliffe-Kaufmann L, Fuente-Mora C, Percival L, Mendoza-Santiesteban C, Kaufmann H (2014) Current treatments in familial dysautonomia. Expert Opin Pharmacother 15:2653–2671CrossRefPubMedPubMedCentral Palma JA, Norcliffe-Kaufmann L, Fuente-Mora C, Percival L, Mendoza-Santiesteban C, Kaufmann H (2014) Current treatments in familial dysautonomia. Expert Opin Pharmacother 15:2653–2671CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Roback MG, Carlson DW, Babl FE, Kennedy RM (2016) Update on pharmacological management of procedural sedation for children. Curr Opin Anaesthesiol 29[Suppl 1]:S21–35CrossRefPubMed Roback MG, Carlson DW, Babl FE, Kennedy RM (2016) Update on pharmacological management of procedural sedation for children. Curr Opin Anaesthesiol 29[Suppl 1]:S21–35CrossRefPubMed
Metadaten
Titel
Intranasal dexmedetomidine for adrenergic crisis in familial dysautonomia
verfasst von
Christy L. Spalink
Erin Barnes
Jose-Alberto Palma
Lucy Norcliffe-Kaufmann
Horacio Kaufmann
Publikationsdatum
03.07.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Clinical Autonomic Research / Ausgabe 4/2017
Print ISSN: 0959-9851
Elektronische ISSN: 1619-1560
DOI
https://doi.org/10.1007/s10286-017-0442-6

Weitere Artikel der Ausgabe 4/2017

Clinical Autonomic Research 4/2017 Zur Ausgabe

Neu in den Fachgebieten Neurologie und Psychiatrie