Midazolam

Question 1

** Midazolam **
Drug Class

Answer 1

Benzodiazepine– Short acting CNS depressant.

• Enhances the action of GABA which causes sedation and anticonvulsive characteristics.

Question 2

** Midazolam **
Onset

Answer 2

IV / IO: 1-3 minutes
IM: 5-15 minutes

Question 3

** Midazolam**
Indications

Answer 3

• Prolonged seizure activity - generalised seizure (≥ 5 minutes) or recurrent seizures
• Focal seizure activity (≥ 5 minutes) with GCS ≤ 12
• Second-line IV agent for sedation maintenance after Droperidol

Question 4

** Midazolam**
Contraindications

Answer 4

Hypersensitivity to Midazolam

Question 5

Midazolam
Dose

Answer 5

IV/IO Dilute 15 mg / 3 ml with 12 ml NaCl in 20 ml syringe (equivalent to 1 mg/ml)

Adult < 70 years:
IM
Initial dose:
5 mg
Repeat 5 mg once after 10 min if needed and no IV access.

IV/IO
Initial dose:
2.5 - 5 mg
Repeat 2.5 mg every 5 min as needed (total max dose 15mg)

Adult ≥ 70 years or frail:
IM
Initial dose:
2.5 mg
Repeat 2.5 mg once after 10 min if required and no IV access.

IV/IO
Initial dose:
2.5 mg
Repeat 1 mg every 5 min as needed (Total max 15mg)

Paediatric:

IM
Initial dose:
0.2 mg/kg (max bolus dose 5 mg)
Repeat initial dose once after 10 min if needed and no IV access.

IV/IO
Initial dose:
0.1 mg/kg (max bolus dose 2.5 mg)
Repeat initial dose as needed every 5 min (Total max dose 10mg)

Question 6

** Midazolam**
Side Effects

Answer 6

• Respiratory depression
• Hypotension
• Anterograde and retrograde amnesia
• Myasthenia Gravis