Midazolam Flashcards

1
Q

Brand name

A

versed

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2
Q

classification

A

benzo

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3
Q

mechanism of action

A

potentiates binding of GABA to the GABA-A receptor, keeping the Cl- channels open and hyperpolarizing the cell, making it resistant to excitation

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4
Q

structure

A

water soluble imidazole ring

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5
Q
pharmacokinetics
PB
lipid solubility
VD
elimination
A

90-98% PB
highly Lipid soluble (rapidly crosses BBB)
VD - 1-1.5L/Kg (large)
elimination: CYP450, excreted urine

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6
Q

pharmacokinetics
onset
doa
T1/2

A

onset - 30-60 sec
doa - 15-80 min
T1/2 - 1-4 hrs, redose in 5 min

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7
Q

active metabolite

A

1-hydroxy midazolam (1/2 as potent)

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8
Q

side effects

A

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

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9
Q

contraindications

A
pregnancy
decrease dose in hepatic/renal pts
caution w/ elderly
synergistic with opioids
DO NOT give with glaucoma
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10
Q

dose

A

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

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