MIDAZOLAM Flashcards
1
Q
Actions and side effects
A
Midazolam is a CNS depressant that enhances the action of the inhibitory neurotransmitter gammaamino butyric acid (GABA). This creates sedation, amnesia, hypnosis and anaesthesia
SIDE EFFECTS • Hypertension • Respiratory depression especially when associated with other CNS depressants including alcohol and narcotics
2
Q
Indications, contraindications & precautions
A
Generalized seizures/focal
seizures (GCS ≤12)
• KSAR
• Can cause severe respiratory depression in patients with COPD • Reduced dosages should be used in older people, patients with chronic renal failure, congestive heart failure or shock • Respiratory tract burns
3
Q
Dosages
A
Adult: EMT 2 NAS ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg) EMT 2 IM ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg) EMT 2 IV Dilute 5mg/1ml Midazolam with 4ml NaCl 0.9% ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg)
Paedeatric: EMT 2 NAS 200mcg/kg Single dose not to exceed 5mg Repeat every 10 mins at half initial dose if required (do not exceed 2.5mg) Max dose 10mg EMT 2 IM 200mcg/kg Single dose not to exceed 5mg Repeat every 10 mins at half initial dose if required (do not exceed 2.5mg) Max dose 10mg EMT 2 IV Dilute 5mg/1ml Midazolam with 4ml NaCl 0.9% 100mcg/kg Single dose not to exceed 2.5mg Repeat every 5mins if required Max dose 10mg ADULT DOSAGE Seizures (GCS <12) LEVEL ROUTE DOSAGE EMT 2 NAS ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg) EMT 2 IM ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg) EMT 2 IV Dilute 5mg/1ml Midazolam with 4ml NaCl 0.9% ≥70yrs - 2.5mg Repeat every 10 mins if required (max dose 10mg) <70yrs - 5mg Repeat every 10 mins if required (max dose 20mg) WEIGHT DOSE VOLUME <5kg 1mg 0.2ml 5-<10kg 2mg 0.4ml 10-<15kg 3mg 0.6ml 15-20kg 4mg 0.8ml >20kg 5mg 1ml ONSET DURATION HALF-LIFE IM 5-15mins IV 1-3mins NAS 1-3mins Variable 2-3 hours WEIGHT DOSE VOLUME <5kg 0.5mg 0.1ml 5-<10kg 1mg 0.2ml 10-<15kg 1.5mg 0.3ml 15-20kg 2mg 0.4ml >20kg 2.5mg 0.5ml
