Sedatives

Question 0

Action of Versed

Answer 0

1. Hypnotic, amnesia, sedative, anticonvulsant
2. Potent but short acting, 3 to 4 times more potent than diazepam
3. Has no effect on pain

Question 1

Midazolam classification

Answer 1

Tranquilizer, benzodiazepine

Question 2

Versed onset of action

Answer 2

IV – 1.5 to 5 minutes
IN – 2 to 6 minutes
IM- 15 minutes

Question 3

Versed duration of action

Answer 3

2 to 6 hours

Question 4

Indication of Versed

Answer 4

1. Premedication prior to cardioversion
2. Acute anxiety
3. Premedication prior to paralytics
4. Post intubation sedation
5. Seizures

Question 5

Contraindication of Versed

Answer 5

1. Narrow angle glaucoma

2. Shock and alcoholic coma

Question 6

Use with caution Versed

Answer 6

Resuscitative equipment available
Monitor vitals for respiratory depression
Accentuated by narcotics and alcohol

Question 7

Dosage and administration of Versed

Answer 7

Adult: 2mg increments to max dose of .1 Mg/kg or 10mg (which ever is less) IV/IO/IM
Give 1/2 dose if > 60 years old
Pediatric: .2mg/kg IM or .1mg/kg IV slowly over two minutes and no greater than 2mg increments, not to exceed 5mg
Adult and pediatric IN for seizures: .2mg/kg of 5mg/ml concentration

Question 8

Adverse reaction of Versed

Answer 8

1. Hypotension, respiratory depression, apnea, laryngospasm, bronchospasm, bradycardia, tachycardia, PVCs
2. May decrease ICP in head injury patients
3. Nasal burning for 30 to 45 sec post IN

Question 9

Versed referenced in protocol

Answer 9

Traumatic emergencies for seizure, crush injury
Cardiac emergencies
Medical emergencies, actively seizing
RSI
Behavioral emergencies, combative patient

Question 10

Classification of diazepam

Answer 10

Anticonvulsant, anti-anxiety, sedative

Question 11

Action of diazepam

Answer 11

Depress central nervous system

Question 12

Onset of action for diazepam

Answer 12

1-5 min, peak action 5-10 min

Question 13

Duration of action for diazepam

Answer 13

15–60 min

Question 14

Indications for diazepam

Answer 14

1. Seizure secondary to head trauma or DTs
2. Status epilepticus
3. Prior to pacing, cardioversion, and RSI. For relief of anxiety & tension and amnesia
4. Envenomation’s resulting in muscle spasm
5. Severe anxiety

Question 15

Contraindication of diazepam

Answer 15

Interaction with other CNS depressants

Question 16

Use with caution for diazepam

Answer 16

Elderly
Inadequate pulmonary function
Liver and or kidney disease
History of drug addiction

Question 17

Dosage and administration for diazepam

Answer 17

Adult: 2-10mg IV/IM/IO
Ped: 0.2mg/kg IV/IO in increments no> than 2mg, Max dose 10mg. Wait 1-2 min between doses to observe effect. Rectally, 0.5mg/kg to max dose of 20mg. Wait at least five min between doses. Contact MBCH for repeat dose

Question 18

Adverse reaction for diazepam

Answer 18

CNS depression, ataxia, transient hypotension, respiratory depression
Venous thrombosis and phlebitis at injection site

Question 19

Reference and protocol for diazepam

Answer 19

Traumatic emergencies, seizures, Burns
Cardiac emergencies
Medical emergencies, ALOC if actively seizing
Environmental emergencies, envenomations
Behavioral emergencies, combative patients
RSI