Alpha-2 agonists do not suppress airway reflexes: a) assess ventilation and overall clinical status (circulation, infection, inflammation, etc.); b) taper neuroleptics first; c) reduce administration of alpha-2 agonists to -1 < RASS < 0, then extubation of the trachea, under alpha-2 agonists. The gene discussed is PSMA2; the disease is infection.