midazolam

Question 1

midazolam (class 3)

Answer 1

benzodiazepine

sedative-hypnotic

cns depressant

Question 2

midazolam (actions 2)

Answer 2

produces generalized CNS depression with muscle relaxation

diminishes patient recall (amnestic effects)

Question 3

midazolam (indications 5)

Answer 3

status seizures (lasting less than 2-5 minutes / 2 or more without lucid interval / respiratory compromise

eclampsia (seizures)

conscious sedation prior to SYNCHRONIZED CARDIOVERSION or TRANSCUTANEOUS PACING in the awake patient

RSI for amnesia effects prior to paralysis of skeletal & respiratory muscles

general sedations as needed (anxiety, burns, chemical restraint, misfiring automatic defibrillator

Question 4

midazolam (dosage/route 3)

Answer 4

seizures: 2-5mg IV/IO (discontinue if seizure stops)

conscious sedation prior to SC or pacing, general sedation or RSI: 2-5mg slow IV/IO (1mg/min) prn

anxiety: 1-2mg slow IV or IN

Question 5

midazolam (side effects 5)

Answer 5

respiratory depression or arrest

excessive sedation

laryngospam/bronchospasm

hypotension

nausea/vomiting

Question 6

midazolam (contraindications 4)

Answer 6

known hypersensitivity

shock

acute alcohol intoxication (alcoholic coma)

narrow angle glaucoma

Question 7

midazolam (special information 7)

Answer 7

do not give unless actively seizing

assess repiratory rate/effectiveness & LOC during administration

inject IM drug deep into large muscle mass

IM amount may need to be divided into 2 injestions (IE >2ml of medication) given at 2 different sites; cannot give 10ml all at once into a muscle

cumulative effect with alcohol & sedatives

onset of action 3-5 min. IV. within 15 min IM

potential risk of congenital malformations during first trimester of pregnancy

Question 8

midazolam (pediatric note 3)

Answer 8

refer to pediatric drug guide

give IM in the thigh or appropriate location for pt size

never administer into the buttocks