University:
Western Sydney University
Course:
MEDI 2003 | Clinical Sciences 2
Academic year:

2024
Views:

291

Pages:

1
Author:

Mariam A. A.

Midazolam Indications: Used preoperatively to produce sedation, anxiolytics Amnesic effects Benzodiazepine of choice for pre-operative use for short surgical procedures due to rapid onset and short duration, improved tolerability, & excellent potential for anterograde amnesia Metabolism: CYP3A4 in GIT mucosa & liver Contraindications: Hypersensitivity to midazolam or any ingredient in its formulation Acute angle-closure glaucoma but may be given to patients with open-angle glaucoma who are receiving appropriate therapy Mechanism of Action: Binds to GABA-A receptor complex Opens Cl- channels Hyperpolarization Sedation, anxiolysis Adverse Effects: Fluctuating changes in HR, BP, RR Intravenous: upper airway obstruction, agitation, pyrexia Oral: emesis, nausea, headache, laryngospasm, agitation, insomnia, tolerance, rebound nasal dryness, throat irritation Frequency of Occurring: Intravenous: common Oral: uncommon Pharmacokinetics & Others: Crosses the BBB, distributes into CSF, milk Approximately 94-97% bound to albumin Degree of protein binding is independent of [ ] in plasma Excreted in urine as conjugated metabolite 2-10% of oral dose is excreted into feces t½: 1.5-2.5 hours Dosage: Procedural Sedation: 20-30 seconds 60: start slowly to desired sedative effect <60: titrated by speech, initially 10 more than for >60 Some respond to as little as 1 mg 7.5-10 mg to minimize excessive sedative effects Generally, aiming for a dosage of 0.5-5 mg Older children and adults Weight-based For obese children, dose based on ideal body weight Maintenance: incremental IV doses of ¼ of induction dose