M9 Transmucosal sedation

Question 1

What are the routes for transmucosal sedation?

Answer 1

Oral and nasal

Question 2

What is transmucosal sedation commonly referred to?

Answer 2

Off licence

Question 3

What was buccal midazolam licensed for?

Answer 3

The management of status epilepticus

Question 4

How long does it take for the sedative effect to occur during oral sedation?

Answer 4

20 minutes

Question 5

What does the nasal solution contain?

Answer 5

Midazolam 40mg/1ml
Lidocaine 20mg/1ml

Question 6

How is the midazolam given to patients during nasal administration?

Answer 6

Mucosal atomising device

Question 7

What is the mucosal atomising device attached to?

Answer 7

1ml syringe

Question 8

Why is it good practice to place a cannula?

Answer 8

In case of an emergency

Question 9

Is the nasal sedative effect faster or slower than oral?

Answer 9

Slightly faster

Question 10

What are the 3 drugs commonly use for oral sedation?

Answer 10

Midazolam, diazepam, temazepam

Question 11

What classification of drug is Temazepam?

Answer 11

Class C, schedule 3

Question 12

What is the half life of temazepam?

Answer 12

8 - 10 hours

Question 13

What is the dose of temazepam in adults?

Answer 13

10 - 35mg 1 hour before procedure

Question 14

What is the dose of temazepam in children?

Answer 14

5 - 15mg 1 hour before procedure

Question 15

What is temazepam primarily prescribed for?

Answer 15

Allergies

Question 16

What classification of drug is Diazepam?

Answer 16

Class C schedule 4 part 1

Question 17

How long does it take for diazepam to take effect?

Answer 17

30 - 60 mins

Question 18

How long is the half life of diazepam?

Answer 18

36 - 57 hours

Question 19

What is the dose of a blue diazepam tablet?

Answer 19

10mg

Question 20

What is the dose of a white diazepam tablet?

Answer 20

2mg

Question 21

What is the dose of a yellow diazepam tablet?

Answer 21

5mg

Question 22

What is the dose of diazepam in children?

Answer 22

5mg 1 hour before procedure

Question 23

What is the dose for adults having diazepam for oral sedation?

Answer 23

10mg 1 hour before treatment OR
5mg the night before, 5mg upon wakening, 5mg 2 hours before treatment

Question 24

What are the contraindications of temazepam and diazepam in regards to alcohol and anti-depressants?

Answer 24

They will enhance the effect of both drugs

Question 25

What are some advantages to oral sedation?

Answer 25

Easy to administer, ideal for needle phobics, not expensive to provide

Question 26

What are some of the disadvantages for oral sedation?

Answer 26

No venous access, drugs can take some time to take effect, drug can't be titrated and depth of sedation can't be altered, absorption and elimination can be erratic

Question 27

What happens when a drug is absorbed by the digestive system?

Answer 27

It enters the hepatic portal system being carried through the portal vein into the liver before reaching the rest of the body