50% of candidates passed this question.

The majority of candidates were able to describe the mechanism of action, uses, dose and some side effects of each drug. The better answers were in a table format. It is of course possible to include much of the relevant information without using a table; however without the visual prompt of a table it makes it likely sections will be omitted.

When comparing two drugs it would be useful to note that though they both provide sedation with analgesia they are used in different circumstances. In ICU, dexmedetomidine is mainly used for sedation peri-extubation and may be continued post-extubation but this was not often mentioned.

The pharmacodynamic effects often omitted the cardiovascular and respiratory effects of ketamine (particularly bronchodilation).

The pharmacokinetic information required was not detailed but only minimal marks can be awarded for ‘administered IV with 100% bioavailability, liver metabolism and renal excretion’ which was a common answer. Noting dexmedetomidine is metabolised to inactive metabolites and ketamine is metabolised to norketamine gained marks, specific pathways were not required. Both drugs are licenced for administration intravenously (and ketamine may be administered IM); however other routes of administration are emerging in clinical practice for both drugs.