Midazolam Hydrochloride (Versed®)

Question 1

Versed - Class

Answer 1

• Benzodiazepine
• Sedative-hypnotic
• CNS depressant

Question 2

Versed - Actions

Answer 2

• Produces generalized CNS depression with muscle relaxation

* Diminishes patient recall (amnestic effects)

Question 4

Versed - Indications

Answer 4

• Status Seizures (lasting > 2-5 min./ 2 or more w/o a lucid interval / respiratory compromise)
• Eclampsia (seizures)
• Conscious sedation prior to Synchronized Cardioversion or Transcutaneous Pacing in the awake pt.
• RSI for amnesia effects prior to paralysis of skeletal & respiratory muscles
• General sedation as needed (burns, chemical restraint, misfiring automatic defibrillator)

Question 5

Versed - Dosage Route

1

Answer 5

• Seizures:
  
  • 0.1mg/kg slow IVP (1mg/min) to a maximum dose of 5mg, (discontinue if seizure stops)
  • May be repeated in 5-10 min if needed
    OR
  • 0.2mg/kg IM to a maximum dose of 10mg, (Maximum 2-3 mL volume/injection site)
  • May be repeated in 5-10 min if needed

Question 6

Versed - Dosage Route

2

Answer 6

• Conscious sedation prior to synchronized cardioversion or pacing, or general sedation:
  
  • 2.5 mg slow IVP (1 mg/min), as needed
    OR
  • 2.5 - 5 mg IM, as needed

Question 7

Versed - Dosage Route

3

Answer 7

• RSI:

* 2.5 mg slow IVP (1 mg/min)

Question 8

Versed - Side Effects

Answer 8

• Respiratory depression or arrest
• Excessive sedation
• Laryngospasm/Bronchospasm
• Hypotension
• N/V

Question 9

Versed - Contraindications

Answer 9

• Know hypersensitivity
• Caution in shock state
• Acute alcohol intoxication (alcoholic coma)
• Narrow angle glaucoma

Question 10

Versed - Special Information

Answer 10

• Assess RR/effectiveness & LOC during drug administration
• Inject IM drug deep into a large muscle mass
• IM amount may need to be divided into 2 injections (i.e. >2ml of med) given at 2 different sites; cannot give 10 ml all at once into a muscle
• Cumulative effect with alcohol & sedatives
• Monitor respiratory & cardiac functions continuously during and after admin.
• Onset of action 3-5 min. when given IV and within 15 min. when given IM
• Potential risk of congenital malformations during 1st trimester of pregnancy

Question 11

Versed - Pediatric Note

Answer 11

• Refer to Pediatric Drug Guide
• Give IM in the thigh or appropriate location for pt size
• Never administer into the buttocks