Midazolam Solution

Question 1

Midazolam Solution

Class

Answer 1

Hypnotics, Sedatives and Anxiolytics: Benzodiazepine

Question 2

Midazolam Solution

Presentation

Answer 2

Ampoule: 10mg in 2ml ampoule or 10mg in 5ml
Buccal liquid: 50mg in 5ml
PFS: 2.5mg in 0.5ml, 5mg in 1ml, 10mg in 1ml, 10mg in 2ml

Question 3

Midazolam Solution

Administration

Answer 3

Intravenous (IV)
Intraosseous (IO)
Intramuscular (IM)
Buccal (BU)
Intranasal (IN) (50% in each nostril)

Adult IV slow rate (1mg per 30 secs)
Paed IV Slow Rate (Initial dose over 2-3 mins)

Question 4

Midazolam Solution

Indications

Answer 4

Seizures
Combative with Hallucinations or paranoia and risk to self or others.
Sedation (following medical advice)

Question 5

Midazolam Solution

Contraindications

Answer 5

Shock
Respiratory depression
KSAR
Depressed vital signs or alcohol related altered level of consciousness

Question 6

Midazolam Solution

Dosage

Answer 6

Adult:
Seizure: 2.5mg IV or 5mg IM or 10mg BU or 5mg IN (repeat X 3 prn)
Behavioural Emergency : 5mg IN/IM (Rpt x 2) (Medical Oversight)
Palliative care: 2.5mg SC, alternatively 2.5-5mg Buccal rpt x1
Procedural Sedation: 1 - 2.5mg IV repat at > 5min intervals
5mg IM/IN repeat at > 15 min Intervals

Paed:
Seizure: 0.2mg/Kg IN or 0.1mg/Kg IV/IO (repeat X 3 prn)
Behavioural Emergency: (Medical Oversight) 0.1mg/kg (rpt x 2)
Procedural Sedation: 25mcg/kg IV/IO repeat > 5min intervals
25mcg/kg IM/IN

Question 7

Midazolam Solution

Side Effects

Answer 7

Respiratory Depression
Headache
Hypotension
Drowsiness

Question 8

Midazolam Solution

Additional Info

Answer 8

Midazolam IV should be titrated to effect.
Ensure oxygen and resuscitation equipment are available prior to administration.
The max dose of Midazolam includes that administered by caregiver prior to arrival of practitioner
If patient recommences seizing, regard it as a new event. Administer additional dose and consider medical advice