Midazolam (Versed)

Question 1

Midazolam Classification

Answer 1

Anticonvulsant/Sedative/Hypnotic/Benzodiazepine

Question 2

Midazolam Mechanism

Answer 2

Positive allosteric modulator for GABA receptors -> Binds to benzodiazepine receptor site on Cl- channels and potentiates binding and effects of GABA -> increased intracellular Cl- concentrations -> hyperpolarization

Question 3

Midazolam Pharmacokinetics

Answer 3

Onset: 3-5min IV, 15min IM
Peak: 20-60min
Duration: <2h IV, 1-6h IM
Half Life: 1-4h

Question 4

Midazolam Indications

Answer 4

• Seizure
• Premed for cardioversion or TCP
• Post intubation sedation

Question 5

Midazolam Contraindications

Answer 5

Hypotension

Question 6

Midazolam Side Effects/Adverse Reactions

Answer 6

Hypotension, drowsiness, amnesia, respiratory depression, blurred vision, AMS, N/V

Question 7

Midazolam Dose

Answer 7

Adult:
Premed: 2-5mg slow IV IO IM
Sedation: 2-5mg q5-10min slow IV IO
Seizure: 2-6mg IV; 10mg IM IN

Pedi:
0.2mg/kg slow IV (max 10mg)

Question 8

Midazolam Precautions

Answer 8

• May cause CNS depression and respiratory depression

- Caution with acute EtOH intoxication

Question 9

Midazolam Drug Interactions

Answer 9

Additive effects with CNS depressants and EtOH