Midazolam Hydrochloride Flashcards Preview

AZ DHS DRUG PROFILES > Midazolam Hydrochloride > Flashcards

Flashcards in Midazolam Hydrochloride Deck (20)
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1
Q

Generic Name:

A

Midazolam Hydrochloride

2
Q

Trade Name:

A

Versed

3
Q

Supplied:

A

10mg/2mL vial

4
Q

Class:

A

CNS depressant, Benzodiazepine, Sedative

5
Q

Mechanism of Action:

A
  •  CNS effects are mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA).
  •  Acts at the limbic, thalamic, and hypothalamic levels of the CNS, producing anxiolytic, sedative, hypnotic, and anticonvulsant effects.
  •  Capable of producing all levels of CNS depression, from mild sedation to coma.
6
Q

Indications and Field Use:

A
  • Anti-confulsant
  • Sedation
  • Management of acute agitation/excited delirium (treat cause as well, if possible)
  • Induction for intubation
7
Q

Contraindications:

A

- Hypersensitivity to midazolam

  •  Relative contraindication in: Myasthenia gravis or other neuromuscular disorders; acute alcohol intoxication; severe, chronic obstructive pulmonary disease; and acute pulmonary insufficiency
  •  Pregnancy (relative)
8
Q

Adverse Reactions:

A

CV: Hypotension (especially in patients premedicated with narcotic); cardiac arrest; irregular or fast heartbeat

Resp: Apnea; respiratory depression, respiratory arrest; paradoxical hyperventilation; wheezing or difficulty in breathing; hiccups; coughing

CNS: Emergence delirium; muscle tremor; uncontrolled or jerky movements of body; unusual excitement, irritability, or restlessness; dizziness, light-headedness, or feeling faint; prolonged drowsiness; headache

GI: Nausea and/or vomiting

9
Q

Notes on Administration:

A

Midazolam administered intravenously has been associated with respiratory depression and respiratory arrest, especially when used concomitantly with opioid analgesics for conscious sedation or when rapidly administered. Midazolam may cause phlebitis. May need to adjust midazolam dose down for patients on erythromycin.

10
Q

Incompatibilities/Drug Interactions:

A

Midazolam may potentiate the action of other CNS depressants, including opiate agonists or other analgesics, barbiturates or other sedatives, anesthetics, or alcohol.

11
Q

Adult Dosage: Patients 14 to 60 years of age:

A
  • 2 to 5 mg IM
  • 1 to 10 mg IV/IO, titrate to effect, administer slowly in small increments of no more than 2.5 mg over at least 2 minutes.
12
Q

Adult Dosage: Patients over 60 years of age:

A
  • 1 to 5 mg IM
  • 1 to 3.5 mg IV/IO, titrate to effect, administer slowly in small increments of no more than 1.5 mg over at least 2 minutes.
13
Q

Total Dose:

A

Should not exceed 20 mg

14
Q

For Emergency Intubation:

A
  • 0.1 mg/kg up to 0.3 mg/kg with dosage limit of 20 mg.
  • 0.2 mg/kg IM if no IV/IO access
  • 0.3 mg/kg IN (divided equally into each nostril) if no IV/IO access
15
Q

Pediatric Dosage:

A
  • 0.05 to 0.1 mg/kg slow IV/IO push
  • 0.2 mg/kg IM/IN if no IV/IO access
    (IN dose divided equally in each nostril)
16
Q

Routes of Administration:

A
  •  For IM administration, inject deep into large muscle mass.
  •  For IV bolus and infusion, administer slowly in small increments over at least 2 minutes and allow 2 more minutes between doses to evaluate effect.
  •  For IN administration, use only concentrated Midazolam (5mg/ml). Ideal volume is 0.3-
    0. 5 ml per nostril, maximum is 1ml per nostril. More volume will just run out of nose. Be aware Midazolam causes some nasal burning for 30-45 seconds when administered.
17
Q

Onset of Action:

A

IM - 15 minutes

IV/IO - Immediate

18
Q

Peak Effects:

A

IM - 15 to 60 minutes

IV - 3 to 5 minutes

19
Q

Duration of Action:

A

2 to 6 hours

20
Q

Arizona Drug Box Minimum Supply:

A

10 mg