Midazolam - Versed Flashcards

Midazolam Overview

• Brand Name: Versed
• Classification:
  • Amnesic Agent
  • Sedative/Hypnotic
  • Anticonvulsant
  • Benzodiazepine
  • Anti-anxiety

Mechanism of Action

• Binds to benzodiazepine receptors
• Enhances GABA, leading to:
  • Decreased agitation
  • Muscle relaxation
  • Induction of sleep at high doses

Indications

• Treatment of seizures
• Premedication for synchronized cardioversion/transcutaneous pacing (TCP)
• One of the options for Rapid Sequence Intubation (RSI) premedication
• Management of anxiety disorders

Contraindications

• Not to be used in acute narrow-angle glaucoma
• Should be avoided in shock due to hypovolemia
• Contraindicated in cases of alcohol or drug intoxication

Side Effects

• Cardiovascular:
  • Bradycardia
  • Hypotension
  • Rebound tachycardia
• Neurological:
  • Amnesia
  • Drowsiness
  • Agitation
  • Altered Level of Consciousness (ALOC)
• Respiratory:
  • Potential respiratory depression or arrest
• Gastrointestinal:
  • Nausea and vomiting (N/V)

Precautions

• Caution in elderly patients with impaired respiratory function
• Use carefully in patients with:
  • Renal failure
  • Liver failure
  • Chronic Obstructive Pulmonary Disease (COPD)

Drug Interactions

• Enhanced effects when combined with other CNS depressants or benzodiazepines

Routes of Administration

• Administered via:
  • IV Push (IVP)
  • Intraosseous (IO)
  • Intramuscular (IM)
  • Intranasal (IN)

Onset and Duration

• Rapid onset:
  • 1-5 minutes via IVP/IO/IN
  • 5-15 minutes via IM
• Duration of effect is approximately 2-6 hours

Dosages

• Adult:

  • Pre-cardioversion or TCP: 1.0 - 2.5 mg slow IVP/IO/IN
  • For seizures: 0.1 mg/kg slow IVP/IO/IN or 0.2 mg/kg IM, max 5 mg

• Pediatric:

  • For seizures: 0.1 mg/kg slow IVP/IO/IN or 0.2 mg/kg IM, max 5 mg