Midazolam

Question 1

Pharmacology and presentation of Midazolam?

Answer 1

5mg/1ml

Midazolam is a short-acting CNS depressant with anxiolytic, amnesia, anaesthesia, sedative, anticonvulsant and hypnotic effects. It achieves this by enhancing the action of the inhibitory neurotransmitter gamma-amino butyric acid (GABA). Depressant effects occur at all levels of the CNS, including respiratory drive.

Question 2

Indicators of Midazolam?

Answer 2

• Continuous/recurrent seizures
• Sedation: to maintain intubation, to enable synchronized cardioversion
• Sedation in: the agitated pt, psychostimulant OD
• Severe trauma multiple fractures or severe burns

Question 3

Contraindications of Midazolam?

Answer 3

• Hypersensitivity to benzodiazepines

Question 4

Cautions of Midazolam?

Answer 4

• Consider reduced doses for elderly/frail, patients with chronic renal failure, congestive cardiac failure or shock
• CNS depression effects of benzodiazepines are potentiated in the presence of narcotics and tranquillisers, including alcohol
• Can cause severe respiratory depression, particularly in patients with COPD
• Myasthenia Gravis

Question 5

Side Effects of Midazolam?

(HARD)

Answer 5

• Decreased level of consciousness
• Loss of airway control
• Respiratory depression
• Hypotension.

Question 6

Dosing Regimes of Midazolam?

Answer 6

.

Question 7

Onset and duration of Midazolam?

Answer 7

• Onset = 1-3 minutes IV or 3-5 minutes IM
• Duration = 20-30 minutes