Midazolam Flashcards
Brand name
versed
classification
benzo
mechanism of action
potentiates binding of GABA to the GABA-A receptor, keeping the Cl- channels open and hyperpolarizing the cell, making it resistant to excitation
structure
water soluble imidazole ring
pharmacokinetics PB lipid solubility VD elimination
90-98% PB
highly Lipid soluble (rapidly crosses BBB)
VD - 1-1.5L/Kg (large)
elimination: CYP450, excreted urine
pharmacokinetics
onset
doa
T1/2
onset - 30-60 sec
doa - 15-80 min
T1/2 - 1-4 hrs, redose in 5 min
active metabolite
1-hydroxy midazolam (1/2 as potent)
side effects
lowers CBF and CMRO2
no isoelectric EEG
preserves CO2 response but flattens curve
neuroprotective
decreased SVR, BP at induction
NO CHANGE TO CO, (relatively stable)
does NOT attenuate SNS response to DVL
dose dependent decrease RR and TV if given with opioids
can cause paradoxical excitation
contraindications
pregnancy decrease dose in hepatic/renal pts caution w/ elderly synergistic with opioids DO NOT give with glaucoma
dose
Pre-med - 1-2.5 mlg IV max 5; 0.5 mg/kg PO max 20
induction - 0.1-0.2 mg/kg over 30-60 sec