Midazolam

Question 1

Midazolam Chemical Structure & Importance

Answer 1

Imidazole ring - water soluble at pH <4, closes upon injection & becomes highly lipid soluble – rapid uptake & redistribution/reuptake

Question 2

Midazolam Protein binding

Answer 2

96-98%

Question 3

Midazolam Volume of distribution

Answer 3

1-1.5L/kg

Question 4

Midazolam Clearance

Answer 4

6-8 mL/kg/min

Question 5

Midazolam Elimination half life

Answer 5

1-4 hours in healthy individuals

Question 6

Midazolam Metabolism

Answer 6

Oxidative hydroxylation in liver, glucoronide conjugation in kidneys, metabolites minimally active, not affected by H2 receptor antagonists (cimetidine)

Question 7

Midazolam Exretion

Answer 7

Renal

Question 8

Midazolam CV Effects

Answer 8

~ Decreased: SBP, SVR, CO. Increased: HR (rebound)

Question 9

Midazolam Respiratory Effects

Answer 9

Depressed ventilation with 0.15 mg/kg dose

Question 10

Midazolam CNS Effects

Answer 10

Dose related decrease: CBF, CMRO2

Question 11

Midazolam Things to be aware of

Answer 11

Renal failure has minimal effects on T1/2, Vd & clearance, crosses uretoplacental barrier