Midazolam Flashcards
What is the mechanism of action of Midazolam?
●Midazolam is a benzodiazepine.
●It enhances the activity of Gamma-aminobutyric Acid (GABA) at the GABA receptors within the CNS resulting in anticonvulsant activity, sedation, amnesia, anxiolysis and muscle relaxation.
What are the indications for Midazolam?
●Generalised seizures that continue for more than 5 minutes or reoccurring seizures.
●Acute behavioural disturbance causing a mild to moderate risk to safety that Droperidol is unavailable or ineffective.
●Pain associated with severe muscle spasm or severe anxiety if adequate analgesia is not being achieved with an opiate and Ketamine is inappropriate.
●Sedation, for joint relocation etc.
●Sedation post intubation.
●Severe anxiety associated with COPD.
●Control of anxiety or SOB that does not respond to an opiate during end of life care.
What are contraindications of Midazolam?
●Known severe allergy.
●Age less than 12 for analgesia only.
What are the cautions for Midazolam? (5)
●ALOC -Midazolam will further reduce the LOC.
●Respiratory depression or at high risk of respiratory depression such as severe COPD, morbid obesity, on home BiPAP. -May cause respiratory depression.
●Signs of shock- May worsen.
●Concurrent administration with opiates or Ketamine- Will increase/prolong effects.
●75 years or greater, particularly if frail. -Effects will increase/prolong.
What is the adult IV dose of Midazolam for a seizure?
5mg IV.
Reduce to 3mg if caution is present.
Can be repeated once only after 5 minutes.
What is the adult IM dose of Midazolam for a seizure?
10mg IM undiluted into the lateral thigh. For 13 years and over.
What is the adult dose of Midazolam for acute behavioural disturbance?
10mg IM reduce to 5mg if a caution is present. Can be repeated once after 20mins.
What are the common side effects of Midazolam?
●Sedation.
●Respiratory depression.
●Hypotension.
●Amnesia.
