Midazolam

Question 1

Midazolam - Type

Answer 1

Anticonvulsant and sedative agent

Question 2

Midazolam - Presentation

Answer 2

5mg in 5ml

15mg in 3ml

Question 3

Midazolam - Actions (3)

Answer 3

1. Anticonvulsant - reduces seizure activity
2. Minor tranquilliser
3. Muscle relaxant
   IV onset 1-5 min, duration 2-3 hrs
   IM onset 2-5 min, duration 2-3 hrs

Question 4

Midazolam - Uses (4)

Answer 4

1. Status epileptics - in a pt who has continual or prolonged seizures
2. Mild sedation to permit basic airway management
3. Adjunct to analgesia for injuries where significant muscle spams is present
4. To manage agitated and combative pt

Question 5

Midazolam - Adverse effects (3)

Answer 5

Depression of level of consciousness, leading to:

1. Respiratory depression
2. Loss of airway control
3. Hypotension

Question 6

Midazolam - Contraindication

Answer 6

Known hypersensitivity

Question 7

Midazolam - Precautions (2)

Answer 7

1. Haemodynamic instability

2. Respiratory depression

Question 8

Midazolam - Doses

Answer 8

Seizures
- Adult & Paediatric - 0.1mg/kg IM/IV no max, IV over 2/60

Adjunct to analgesic use with muscle spasm

• Adult and Paediatric - up to 0.05mg/kg IV over 2/60
• rep x 1 as req
• after 1 dose methoxy or 2 doses morphine

Mild sedation to facilitate basic airway management
- Adult and Paediatric - 0.1mg/kg over 2 mins

Post intubation sedation as adjunct to ketamine
- Adult and Paediatric - 0.05mg/kg IV

When used to manage a combative or agitated pt
- Adult and paediatric - up to 0.1mg/kg until manageable.
- may repeat as req to continue management, IV/IM
If agitation and combativeness due to psychostimulant
- up to 0.2mg/kg IM/IV until manageable
All agitated pt management doses may be reduced
- if there is known or suspected hypotension or hypovolaemia
- in frail or elderly pts
- for pts with general debility