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A Case Approach to Perioperative Drug-Drug Interactions pp 179–182Cite as

Dexy’s Midnight Spinal

Dexmedetomidine, bupivacaine spinal, multiple mechanisms, CYP3A4, CYP2D6

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Abstract

This case discusses a possible pharmacokinetic interaction between bupivacaine and dexmedetomidine. Bupivacaine is a cytochrome P450 2D6 and cytochrome 3A4 substrate. Dexmedetomidine has been shown, in vitro, to inhibit both enzymes.

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References

  1. Gantenbein M, Attolini L, Bruguerolle B, et al. Oxidative metabolism of bupivacaine into pipecolylxylidine in humans is mainly catalyzed by CYP3A. Drug Metab Dispos. 2000;28:383–5.

    PubMed  CAS  Google Scholar 

  2. Product information: Precedex(R) IV injection, dexmedetomidine hydrochloride IV injection. Lake Forest: Hospira Inc; 2008.

    Google Scholar 

  3. Tie Y, McPhail B, Hong H, et al. Modeling chemical interaction profiles: II. molecular docking, spectral data-activity relationship, and structure-activity relationship models for potent and weak inhibitors of cytochrome P450 CYP3A4 isozyme. Molecules. 2012;17(3):3407–60.

    Article  PubMed  CAS  Google Scholar 

  4. Rodrigues AD, Roberts EM. The in vitro interaction of dexmedetomidine with human liver microsomal cytochrome P4502D6 (CYP2D6). Drug Metab Dispos. 1997;25(5):651–5.

    PubMed  CAS  Google Scholar 

  5. Saadawy I, Boker A, Elshahawy MA, et al. Effect of dexmedetomidine on the characteristics of bupivacaine in a caudal block in pediatrics. Acta Anaesthesiol Scand. 2009;53(2):251–6.

    Article  PubMed  CAS  Google Scholar 

  6. Al-Mustafa MM, Badran IZ, Abu-Ali HM, et al. Intravenous dexmedetomidine prolongs bupivacaine spinal analgesia. Middle East J Anesthesiol. 2009;20(2):225–31.

    PubMed  Google Scholar 

  7. Kaya FN, Yavascaoglu B, Turker G, et al. Intravenous dexmedetomidine, but not midazolam, prolongs bupivacaine spinal anesthesia. Can J Anaesth. 2010;57(1):39–45.

    Article  PubMed  Google Scholar 

  8. De Wolf AM, Fragen RJ, Avram MJ. The pharmacokinetics of dexmedetomidine in volunteers with severe renal impairment. Anesth Analg. 2001;93(5):1205–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA

    Michael P. Hutchens MD, Edward A. Kahl MD & Matthias J. Merkel MD, PhD

Authors
  1. Michael P. Hutchens MD
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  2. Edward A. Kahl MD
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  3. Matthias J. Merkel MD, PhD
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Corresponding author

Correspondence to Michael P. Hutchens MD .

Editor information

Editors and Affiliations

  1. Anesthesia Services Department, Philadelphia Veterans Affairs Med Center, Philadelphia, PA, USA

    Catherine Marcucci MD

  2. Department of Anesthesiology, Oregon Health and Science University, Portland, OR, USA

    Michael P. Hutchens MD

  3. Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA

    Erica D. Wittwer MD, PhD , Toby N. Weingarten MD , Juraj Sprung MD, PhD  & Wayne T. Nicholson MD, PharmD, MSc , ,  & 

  4. Department of Anesthesiology and Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Kirk Lalwani MD

  5. Department of Anesthesiology, University of Pittsburgh School of Med Liliane S. Kaufmann Building, Pittsburgh, PA, USA

    David G. Metro MD

  6. Department of Anesthesiology, University of Illinois at Chicago, Chicago, IL, USA

    Randal O. Dull MD, PhD

  7. Department of Anesthesiology, Perioperative Medicine, Oregon Health and Science University, Portland, OR, USA

    Christopher E. Swide MD

  8. Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI, USA

    F. Jacob Seagull PhD

  9. Department of Anesthesiology and Perioperative Medicine, Portland, OR, USA

    Jeffrey R. Kirsch MD (Professor and Chair) (Professor and Chair)

  10. Department of Psychiatry, University of Maryland Medical System VA Maryland Health Care System, Baltimore, MD, USA

    Neil B. Sandson MD

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© 2015 Springer Science+Business Media New York

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Hutchens, M.P., Kahl, E.A., Merkel, M.J. (2015). Dexy’s Midnight Spinal. In: Marcucci, C., et al. A Case Approach to Perioperative Drug-Drug Interactions. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7495-1_35

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  • DOI: https://doi.org/10.1007/978-1-4614-7495-1_35

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7494-4

  • Online ISBN: 978-1-4614-7495-1

  • eBook Packages: MedicineMedicine (R0)

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