Midazolam

Question 1

Midazolam - Contraindications (1)

Precautions (7)

Answer 1

Contraindications:
* known hypersensitivity to benzodiazepines

Precautions:
# elderly 
# use of narcotics and other tranquillisers such as alcohol
# COPD (can cause severe respiratory depression)
# CCF
# shock
# myasthenia gravis (progressive muscle weakening without wastage)
# chronic renal failure

Question 2

Midazolam - Side Effects (4)

Answer 2

> depressed conscious state
loss of airway control
respiratory depression
hypotension

Question 3

Midazolam - Actions

Answer 3

A short-acting CNS depressant with anxiolytic, anti-convulsant and sedative actions, used in:

• generalised convulsive status epilepticus
• agitated patient +/- psychostimulant overdose

Question 4

Midazolam - Presentation

Answer 4

5mg in 1ml glass ampoule

Question 5

Midazolam - Dose

GCSE

Answer 5

AD: 10mg in 2ml IM, repeat @ 10/60 once only
Frail: 5mg in 1ml IM, repeat @ 5/60 once only

PD large child 12-16y: 5mg in 1ml IM, repeated @10/60 once only
PD medium child 5-11y: 2.5-5mg in 0.5-1ml IM, repeated @10/60 once only
PD small child 1-4y: 2.5mg in 0.5ml IM, repeated @10/60 once only
PD infant <1y: 1mg in 0.2ml IM, repeated @10/60 once only
PD newborn <24hours: 0.5mg in 0.1ml IM, repeated @10/60 once only

Question 6

Midazolam - Dose

Agitated Patient +/- Psychostimulant Overdose

Answer 6

Mild/Moderate Agitation:

AD: Midazolam 5 - 10mg IM, repeat @ 10/60, max 20mg IM
Frail / PD (<60kg) / BP <100 / Alcohol or Drug Use: Midazolam 2.5 - 5mg IM, repeat @ 10/60, max 20mg IM

Extreme Agitation:

AD/PD: Midazolam up to 20mg IM, repeat @ 10/60, max 40mg IM

Question 7

Midazolam - Onset and Duration

Answer 7

IM effects:

• onset: 3-5mins
• peak: 15mins
• duration: 30mins