Midazolam

Question 1

Midazolam

Classification -

1. ___

Answer 1

Midazolam

Classification -

1. Tranquilizer (Benzodiazepine).

Question 2

Midazolam

Action -

1. _(list of four)_
2. ___
3. ___

Answer 2

Midazolam

Action -

1. Hypnotic, amnesiac, sedative, anticonvulsant.
2. Potent but short-acting, 3-4 times more potent than diazepam.
3. Has NO effect on pain.

Question 3

Midazolam

Onset of Action -

1. IV/IO: ___
2. IN: ___
3. IM: ___

Answer 3

Midazolam

Onset of Action -

1. IV/IO: 1.5-5 minutes.
2. IN: 2-6 minutes.
3. IM: 15 minutes.

Question 4

Midazolam

Duration of Action -

1. IV/IO/IN/IM: ___

Answer 4

Midazolam

Duration of Action -

1. IV/IO/IN/IM: 2-6 hours.

Question 5

Midazolam

Indication -

1. ___
2. ___
3. ___
4. ___

Answer 5

Midazolam

Indication -

1. Premedication sedation prior to cardioversion.
2. Acute anxiety states [including ExDs].
3. Seizures.
4. Post-intubation sedation.

Question 6

Midazolam

Contraindication -

1. ___
2. ___

Answer 6

Midazolam

Contraindication -

1. History of hypersensitivity.
2. Narrow angle glaucoma.

Question 7

Midazolam

Use with Caution -

1. ___
2. ___

Answer 7

Midazolam

Use with Caution -

1. Shock.
2. May be accentuated by narcotics and/or alcohol.

Question 8

Midazolam

Dosage and Administration -

1. Give half doses if patient is ___.
2. Wait ___ minutes between ___ doses to evaluate response.
3. Seizures:
   a. Adult:
   i. 1st choice - ___, or
   ii. 2nd choice - ___
   iii. 3rd choice - ___

Answer 8

Midazolam

Dosage and Administration -

1. Give half doses if patient is > 60 years old.
2. Wait 1-2 minutes between IN/IV doses to evaluate response.
3. Seizures:
   a. Adult:
   i. 1st choice - 10 mg for > 40 kg, single dose IM, or
   ii. 2nd choice - 0.2 mg/kg of a 5 mg/mL concentration IN, or
   iii. 3rd choice - 2 mg increments IV to a maximum dose of 0.1 mg/kg or 10 mg (whichever is less).

Question 9

Midazolam

Dosage and Administration -

1. Seizures:
   a. Pediatric:
   i. 1st choice - ___, or
   ii. 2nd choice - ___, or
   iii. 3rd choice - ___

Answer 9

Midazolam

Dosage and Administration -

1. Seizures:
   a. Pediatric:
   i. 1st choice - 5 mg for 13-40 kg, single dose IM, or
   ii. 2nd choice - 0.2 mg/kg of a 5 mg/mL concentration IN, to a maximum dose of 10 mg, or
   iii. 3rd choice - 0.1 mg/kg IV slowly over 2 minutes in no greater than 2 mg increments not to exceed 5 mg.

Question 10

Midazolam

Dosage and Administration -

1. Anxiety Relief/Sedation: e.g. CPAP, pre-cardioversion, behavioral - not ExDs (specific doses/routes in protocol sections):
   a. Adult:
   i. ___
   ii. ___
   iii. ___

Answer 10

Midazolam

Dosage and Administration -

1. Anxiety Relief/Sedation: e.g. CPAP, pre-cardioversion, behavioral - not ExDs (specific doses/routes in protocol sections):
   a. Adult:
   i. 0.2 mg/kg of a 5 mg/mL concentration IN, or
   ii. 2 mg increments IV/IO to a maximum dose of 0.1 mg/kg or 10 mg (whichever is less), or
   iii. 5 mg IM; may repeat once in 10-15 minutes.

Question 11

Midazolam

Dosage and Administration -

1. Anxiety Relief/Sedation:
   a. Pediatric:
   i. IN: ___, or
   ii. IM: ___, or
   iii. IV: ___
   iv. ___ for direction if unsure.

Answer 11

Midazolam

Dosage and Administration -

1. Anxiety Relief/Sedation:
   a. Pediatric:
   i. 0.2 mg/kg of a 5 mg/mL concentration IN, to a maximum dose of 5 mg, or
   ii. 0.2 mg/kg IM< to a maximum of 5 mg, or
   iii. 0.1 mg/kg IV slowly over 2 minutes in no greater than 2 mg increments not to exceed 5 mg. iv. Contact Mary Bridge Base Station for direction if unsure.

Question 12

Midazolam

Dosage and Administration -

1. Excited Delirium Sedation:
   a. Adult: ___ IN/IM/IV.

Answer 12

Midazolam

Dosage and Administration -

1. Excited Delirium Sedation:
   a. Adult: 10 mg IN/IM/IV.

Question 13

Midazolam

Dosage and Administration -

1. Excited Delirium Sedation:
   a. Pediatric: ___

Answer 13

Midazolam

Dosage and Administration -

1. Excited Delirium Sedation:
   a. Pediatric: Contact Mary Bridge Base Station for direction.

Question 14

Midazolam

Dosage and Administration -

1. Post-RSI:
   a. Adult: ___

Answer 14

Midazolam

Dosage and Administration -

1. Post-RSI:
   a. Adult: 2 mg IV/IO q 10 minutes as needed.

Question 15

Midazolam

Dosage and Administration -

1. Post-RSI:
   a. Pediatric: ___

Answer 15

Midazolam

Dosage and Administration -

1. Post-RSI:
   a. Pediatric: 0.1 mg/kg IV/IO slowly over 2 minutes in no greater than 2 mg increments, q 10 minutes as needed.

Question 16

Midazolam

Adverse Reaction -

1. _(list of 12)_
2. ___
3. ___

Answer 16

Midazolam

Adverse Reaction -

1. Drowsiness, Hypotension, Amnesia, Respiratory depression, Apnea, Laryngospasm, Bronchospasm, Dyspnea, Bradycardia, Tachycardia, PVCs, Retching. 2. May decrease ICP in head injured patients.
2. Causes nasal burning for 30-45 seconds post IN administration.