Article Contents ::
Details About Generic Salt :: Midazolam
Main Medicine Class:: Anti Infectives Sub Medicine Class :: Miscellaneous
| 1A. SEDATIVES & HYPNOTICS in 1. NERVOUS SYSTEM |
| MIDAZOLAM |
| SHORT-ACTING BENZODIAZEPINE | SEDATIVE & HYPNOTIC, ADJUNCT FOR GENERAL ANESTHESIA INDUCTION |
| also comes under 16C. Miscellaneous in 16. Anesthetics |
| PK: A: Rapid (PO) D: 1-3.1 L/kg (Vd) M: Hepatic E: Urine & feces (2%-10%) |
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Indications & Dose: CONSCIOUS SEDATION PO Child 0.25-0.5mg/kg single dose, max 20mg 30-60min before procedure | IV Adult Initially 0.5-2mg over 2min, repeat dose q2-3min if needed, reduce dose by 30% if narcotics/other CNS depressants used Child Same as preoperative sedation Elderly Initially 0.5mg slowly at least 2min | IM Child 0.1-0.15mg/kg 30-60min before surgery/procedure, max 10mg | INDUCTION OF ANESTHESIA IV Adult Unpremedicated patients: 0.3-0.35mg/kg, premedicated patients: 0.15-0.35mg/kg MD 0.05-0.3mg/kg as needed Child 7–18 yr: 150µg/kg slowly max 7.5mg given in steps of 50µg/kg max 2.5mg over 2-5min, additional doses of 50µg/kg max 2.5mg q2min if needed | PREOPERATIVE SEDATION PO Child 0.25-0.5mg/kg single dose, max 20mg 30-60min before procedure | IV Adult 0.02-0.04mg/kg, repeat q5min max 0.1-0.2mg/kg Child 6 months-5 yr: Initially 0.05-0.1mg/kg max total dose 6mg, 6-12 yr: Initially 0.025-0.05mg/kg max total dose 10mg, 12-16 yr: max 10mg | IM Adult 0.07-0.08mg/kg 30-60min before surgery/procedure Child 0.1-0.15mg/kg 30-60 min before surgery/procedure, max 10mg | SEDATION IN INTENSIVE CARE Short-term therapy PO Adult 7.5-15mg HS |
| Contra: Hypersensitivity, acute closed-angle glaucoma
Precautions: Pulmonary disease, HF, renal/ severe hepatic impairment, obese child, elderly/debilitated patients, children/neonates ADR: Serious: Hypotension, paradoxical reaction, seizure-like activity, decreased respiratory rate, phlebitis, bronchospasm, Others: acid taste, amnesia, bradycardia, tachycardia, drowsiness, over sedation, physical & psychological dependence, rash DDI: Serious Verapamil/Diltiazem causes deep sleep & prolonged hypnosis, Carbamazepine decreases drug effect, Clarithromycin/Azithromycin/Erythromycin/Lopinavir/Nelfinavir/Ritonavir/Roxithromycin increases drug level, Azoles increases drug plasma level & increases sedation, Alcohol increases risk of drowsiness, impairs performance & driving skills Others Fentanyl causes respiratory depression, hypotension, Halothane potentiates anesthetic action of drug Diet: Monitor: Respiratory & CV status, BP |