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11 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the best-known trade name for midazolam?
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Versed
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Other trade names include Dormicum and Hypnovel.
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What is the functional class of midazolam?
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Benzodiazepine
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There are about 35 benzodiazepines that have been formulated and are used medically, several are not approved for use in the US.
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What is the mechanism of action of midazolam?
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This short-acting benzodiazepine intensifies activity of GABA.
It also has CNS depressant, anticonvulsant and anterograde amnestic properties. It also relaxes skeletal muscles and induces sleep. |
An amnestic is a drug that induces amnesia.
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What are the listed indications for midazolam?
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- Seizures (status epilepticus)
- To induce sedation prior to painful procedures |
Unlike diazepam and lorazepam, midazolam is not indicated for acute anxiety.
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What are the listed contraindications for midazolam?
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- Hypersensivity to benzodiazepines
- Acute narrow-angle glaucoma - Coma - Shock - Acute alcohol intoxication |
These are the same as the contraindications for lorazepam.
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What are the listed precautions for midazolam?
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Use with caution in patients with COPD, CHF and/or renal failure.
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Many sources include hypotension as a precaution or relative contraindication.
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What are the listed side effects of midazolam?
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- N/V
- Burred vision - Retrograde amnesia - Excessive amnesia - Apnea - Hypotension - PVCs |
PVCs (premature ventricular contractions/complexes) occur when the heartbeat is initiated by the heart ventricles rather than by the sinoatrial node.
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What are the listed interactions of midazolam?
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- Prolonged respiratory depression when given in conjunction with other CNS depressants such as alcohol
- Cimetidine (Tagamet) increases plasma levels of midazolam. |
The interactions of all three prehospital benzodiazepines are very similar.
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What is the dosage and route of midazolam?
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Adult:
- 1.0 - 2.5mg slow IVP or IM q 5 min until seizure abolished Pedi: - 0.1mg/kg slow IVP or IM, maximum single dose 6mg, may repeat once after 5 minutes |
There is evidence that buccal and intranasal midazolam are easier to administer and more effective than rectally administered diazepam for the control of seizures.
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What are the pharmacokinetics of midazolam?
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Onset: 3 - 5 minutes IV
Duration: <2 hours IV Half-Life: 1 - 4 hours |
The duration of apparent action is considerably less than the half-life. Noticeable effects wear off within a few hours but as long as the drug is present it will exert subtle effects. These effects may become apparent during continued use or may appear as withdrawal symptoms when dosage is reduced or the drug is stopped.
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What medication is an antagonist to midazolam?
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Flumazenil
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Flumazenil has also been found to be effective in overdoses of non-benzodiazepine sleep enhancers, such as zolpidem (Ambien) and zaleplon (Sonata).
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