1
Q

midazolam preparation

A

5mg/5ml

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2
Q

midazolam is metabolised in….

A

the liver

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3
Q

midazolam half life

A

90-150 mins

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4
Q

how to treat midazolam over sedation

A

Flumanezil
500mcg in 5ml

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5
Q

flumazenil dose

A

200mcg then 100mcg increments every 60 seconds until a response is seen

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6
Q

fumazenil downsides

A

shorter half life than midazolam
- 50 mins
risk of re-sedation

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7
Q

over sedation - signs and symptoms

A

loss of responsiveness
respiratory depression
loss of ability to maintain airway
respiratory arrest

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8
Q

management of respiratory depression

A

check oximeter
stimulate patient
- ask them to breathe
supplemental oxygen
- nasal cannula 2 litres per minute
reverse with flumazenil

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9
Q

Effects of benzodiazepines

A

respiratory depression
- CNS depression and muscle relaxation
reduced blood pressure by muscle relaxation decreasing vascular resistance
- increase heart rate due to baroreceptor reflex

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10
Q

benzodiazepines side effects

A

drug interactions
- other CNS depressants
- erythromycin
- antihistamines
tolerance
dependence
sexual fantasies

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11
Q

IV sedation procedure

A

cannulation
pulse oximeter
BP monitoring
drug administration
- 2mg bolus
- 1mg increments every 60 seconds
- until suitable level of sedation

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12
Q

iv sedation - signs patient is adequately sedated

A

slurring and slowing of speech
relaxed
delayed response to commands
willingness to accept treatment

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