Table 2.

Pharmacological synopsis

	Dexmedetomidine	Remifentanil	Propofol	Midazolam	Ketamine
Mechanism of action	Short-acting alpha 2 adrenoceptor agonist	Short-acting opioid with a µ-selectivity	GABAA receptors activation	GABAA receptors activation	NMDA antagonistic action
Doses used during NIV	Bolus: 1 µg/kg (optional) Maintenance: 0.2–0.7 µg/kg/h Step up-down: 0.1 µg/kg/h	Maintenance: 0.025 µg/kg/min Step up-down: 0.01 µg/kg/min every minute	Maintenance: 0.4 µg/mL Step up-down: 0.2 µg/mL	Bolus: 0.05 µg/kg Maintenance: 0.05–0.1 µg/kg/h Step up-down: 0.05 µg/kg/h	No data during NIV
Respiratory drive modulation	Minimal	Moderate	Elevated	Elevated	Minimal
Sedative effect	Moderate	Moderate	Elevated	Elevated	Moderate
Analgesia	Moderate	Elevated	Minimal	Minimal	Elevated
Downsides	Bradycardia Hypotension Hemodynamic depression	Risk of accumulation Nausea and vomiting Hemodynamic depression Chest wall rigidity	Respiratory depression Hemodynamic instability Airway instability and aspiration	Accumulation Paradoxical agitation Amnesia Delirium	Salivary secretions Nausea and vomiting Altered mental status Visual hallucinations

GABA_A γ-aminobutyric acid type A, NMDA N-methyl-D-aspartic acid, NIV non-invasive ventilation