midazolam Flashcards
(6 cards)
Indication
Generalised seizures that continue for more than five minutes, or seizures are recurrent.
Acute behavioural disturbance causing a mild to moderate risk to safety and 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 not appropriate.
Sedation, for example, for joint relocation.
Severe anxiety associated with COPD.
Control of anxiety or shortness of breath that does not respond to an opiate during end of life care.
Contraindications and cautions
Contraindications
- Known severe allergy.
- Aged less than 12 years (analgesia only).
Cautions
- Altered level of consciousness. Midazolam will further reduce the level of consciousness.
- Respiratory depression or at high risk of respiratory depression. For example, severe COPD, morbid
obesity or on home BiPAP. Such patients may develop respiratory depression following midazolam administration. - Signs of shock. Midazolam may make shock worse.
- Concurrent administration of opiates or ketamine. This will increase and prolong the effects.
-Aged greater than or equal to 75 years, particularly if frail. The effects of midazolam will be increased and prolonged in this cohort
Action
Midazolam is a benzodiazepine. It
enhances the activity of gamma-
aminobutyric acid (GABA) at GABA
receptors within the central nervous
system, resulting in anticonvulsant
activity, sedation, amnesia, anxiolysis
and muscle relaxation.
Route
IV / IO / SC / IM
Dosage
IV: 5mg seizure,
IV: Depends see CPGs ABD - 2-3mg repeat every 5 minutes Anxiety , mucle spasm - 0.5-1mg (0.5 for COPD)
IM: 10mg
Side effects
Common adverse effects include:
- sedation,
- respiratory depression,
- hypotension
- amnesia.
The effects will be increased and prolonged in the presence of other sedatives or pain relieving
medicines (for example other benzodiazepines, opiates, ketamine and alcohol).
