Midazolam

Question 1

What is a standard adult pre-operative anxiolytic midazolam dose?

Answer 1

0.5 - 2 mg IV
or
0.01-0.02 mg/kg

Stoelting’s Pharmacology 5th, Ch. 5, pg. 176

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Question 2

Induction dose of Midazolam

Answer 2

0.1 - 0.3 mg/kg

Stoelting’s Pharmacology 5th, Ch. 5, pg. 177

Question 3

Midazolam MoA

Answer 3

• Does NOT directly activate GABA-a receptors,
• Binds to the α subunit of the GABA chloride channel, increasing affinity for GABA
• Stimulating more frequent channel openings

Hyperpolarizes the neuronal cells due to Cl- influx (Intracellularly more negative)

Stoelting’s Pharmacology 5th, Ch. 5, pg. 172

Question 4

Midazolam IV Onset/Peak

Answer 4

Onset: 1-5 min
Peak: 3-5 min

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Question 5

Midazolam IV Duration of Action

Answer 5

2 - 6 hrs

Closer to 2 hrs in most pts

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Question 6

How is Midazolam Metabolized/Eliminated?

Answer 6

Metabolism: Liver (CYP3A4)
Elimination: Kidneys

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