Midazolam

Question 1

Midazolam Trade Name?

Answer 1

Midazolam (Versed) (Not Carried by Nuvance)

Question 2

Midazolam Classification?

Answer 2

Benzodiazepine

Question 3

Midazolam Mechanism?

Answer 3

Capital/Medscape/Statpearls:
Binds to specific sites on GABA-A receptors to potentiate the effects of GABA by increasing the frequency at which the chloride channel opens, leading to hyperpolarization of the neuronal membrane and reduced neuronal excitability. Its inhibitory action in the amygdala is beneficial in anxiety disorders, while its inhibitory activity in the cerebral cortex is beneficial in seizure disorders.

Question 4

Midazolam Indications?

Answer 4

CT Protocols:
Seizure, Sedation, Anxiolytic, Alcohol withdrawal, Post-intubation sedation

Question 5

Midazolam Contraindications?

Answer 5

Capital: Hypersensitivity, Respiratory insufficiency, Hypotension

Question 6

Midazolam Side Effects/Precautions?

Answer 6

Capital: Dizziness, Drowsiness, Confusion, Hypotension, Nausea/vomiting, Respiratory depression

Question 7

Midazolam Adult Dose?

Answer 7

Capital: 2-10 mg IV/IO/IM/IN repeated in 5-10 minutes
CT Protocols:
Alcohol Withdrawal, Bradycardia/Transcutaneous Pacing, CPAP/BPAP, Hyperthermia, Nerve Agent, Poisoning/Substance Abuse/OD, Restraints, Tachycardia/Cardioversion
2.5mg IV/IO(preferred) may repeat once in 5 minutes
5mg IM/IN; may repeat once in 10 minutes
Post Intubation Sedation
2-5 mg IV/IO every 5-10 minutes as needed
Seizure
>39 kg, 10 mg IM (preferred route) every 10 minutes or
5 mg IV/IO/IN every 5 minutes
≤39 kg, 5 mg IM (preferred route) every 10 minutes or 5
mg IV/IO/IN every 5 minute

Question 8

Midazolam Pediatric Dose?

Answer 8

Capital: 0.1 mg/kg (max 10 mg) IV/IO/IM/IN repeated in 5-10 minutes

Question 9

Midazolam Onset of Action?

Answer 9

Medscape: 3-5 min (IV), 15-20 min (IM, PO);

Question 10

Midazolam Duration of Action?

Answer 10

Medscape: 20-40 min (IV); 1-6 hr (IM), Duration anterograde amnesia: 1 hr (IM)

Question 11

Midazolam Max Dose Adult/Pediatric?

Answer 11

Capital: 10mg

Question 12

Midazolam Routes of Administration?

Answer 12

IV/IO/IM

Question 13

Midazolam How Supplied?

Answer 13

Capital:
1mg/ml and 5mg/ml vials and ampules
Quickest acting of benzodiazepines
May be mixed with Haldol in same syringe for sedation of violent patients
Decrease dose by 50% in patients with renal and hepatic dysfunction
Versed has Hypnotic effect that other Benzos do not.