Midazolam

Question 1

Drug class

Answer 1

Benzodiazepine (short acting)

Question 2

Pharmacology

Answer 2

A short acting CNS depressant that enhances the action of gamma-amino butyric acid (GABA), an inhibitory neurotransmitter. It induces amnesia, anaesthesia, hypnosis & sedation. Depressant effects occur at all levels of the CNS

Question 3

Metabolism

Answer 3

By the liver & excreted by the kidneys

Question 4

Indications

Answer 4

• Generalised seizure / focal seizure (GCS ≤12)
• Sedation
• ABD (SAT ≥ 2 unresponsive to max dose of droperidol

Question 5

Contraindications

Answer 5

Allergy and/or adverse drug reaction

Question 6

Precautions

Answer 6

• Reduced dosages
  - low body weight, older or frail
  - chronic renal failure, CCF, shock
•  COPD - can cause severe resp depression
• Myasthenia gravis 
• Multiple sclerosis

Question 7

Side effects

Answer 7

• Hypotension

* Resp depression (particularly with other CNS depressants incl. ETOH & narcotics)

Question 8

Presentation

Answer 8

5mg/1ml amp

Question 9

Routes

Onset

Duration

Answer 9

NAS/IM/IV

O: IM 5-15min
IV 1-3min

D: Variable

Question 10

Adult Dosages

Answer 10

Generalised seizure / focal activity (GCS ≤12)
• NAS / IM
▪︎5mg, repeated every 10mins, total max dose 20mg
• IV
▪︎5mg, repeated every 5mins, total max dose 20mg

▪︎ABD
IM / IV - CONSULT

Question 11

Paediatric dosages

Answer 11

Generalised seizure / focal seizure (GCS ≤12)

NAS / IM
200mcg/kg, single dose not to exceed 5mg
Repeated at half the initial dose (max 2.5mg) at 10min intervals
Total max dose 10mg