Midazolam

Question 1

What is Midazolam?

Answer 1

A parenteral benzodiazepine used for various medical indications

Midazolam is commonly used in emergency medicine for sedation and seizure control.

Question 2

List the indications for Midazolam.

Answer 2

• Prolonged/repeated seizures
• Acute Behavioral Disturbance with SAT ≥ +2
• Traumatic or hypoxic brain injury
• Post-ictal agitation
• Pacing and cardioversion
• Advanced airway analgesia and sedation
• Anxiety with pain
• CPR Induced Consciousness (CPRIC)

SAT refers to the Severity Assessment Tool used to evaluate behavioral disturbances.

Question 3

What are the methods of administration for Midazolam?

Answer 3

• IM
• IV
• IO

IM stands for Intramuscular, IV for Intravenous, and IO for Intraosseous administration.

Question 4

What patient factors increase susceptibility to Midazolam-induced respiratory depression?

Answer 4

• Patients with respiratory disease
• Elderly/frail patients

These populations may experience increased risks when using sedatives like Midazolam.

Question 5

What is the onset of action for Midazolam via IM and IV/IO routes?

Answer 5

• 15 minutes (IM)
• 5 minutes (IV/IO)

The rapid onset of action makes Midazolam effective for acute situations.

Question 6

What is the duration of action for Midazolam?

Answer 6

20-60 minutes

Duration may vary based on the dosage and patient factors.

Question 7

What is the maximum volume for an IM injection of Midazolam?

Answer 7

5 mL per IM injection site

This limit helps to avoid tissue trauma and ensure effective delivery.

Question 8

What should be administered if seizure is not controlled after 2 doses of Midazolam?

Answer 8

Levetiracetam (ICP only)

This is recommended to manage seizures effectively.

Question 9

What should be considered for patients requiring anxiolysis and analgesia?

Answer 9

Co-administration with fentanyl

Fentanyl can enhance analgesic effects when used with Midazolam.

Question 10

True or False: The onset of clinical response to Midazolam may be delayed.

Answer 10

True

This emphasizes the need for careful monitoring after administration.

Question 11

What are some notable adverse effects of Midazolam?

Answer 11

• Hypotension
• Hiccup
• Cough

Awareness of these effects is important for patient safety.

Question 12

Fill in the blank: If Midazolam is instilled too quickly, systemic bioavailability is reduced by _____%.

Answer 12

50

This reduction can impact the effectiveness of the treatment.