Name

midazolam hydrochloride (Versed®)

Class

Short acting benzodiazepine

Sedative/Hypnotic

Description/Mechanism

Like all benzodiazepines, enhances the inhibitory effects of GABA receptors on chloride channels in central nervous system, hyperpolarizing membrane. Induces sleep, decreases anxiety, and impairs memory retention.

Onset

1-3 min IV, dose dependant

Duration

2-6 hours, dose dependant

Indications

Premedication for tracheal intubation or cardioversion

Anxiety

Contraindications

Hypersensitity

Depressed vital signs

Concomitant use of barbiturates, alcohol, narcotics, or other CNS depressants

Adverse Reactions

Hiccough

Cough

Oversedation

Pain at the injection site

Nausea and vomiting

Headache

Blurred vision

Hypotension

Respiratory depression/arrest (especially when given very rapidly).

Drug Interactions

Sedative effect of midazolam may be accentuated by concomitant use of barbiturates, alcohol or narcotics.

Supplied

2,5,10ml vials (1mg/ml)

1,2,5,10ml vials (5mg/ml)

Dose/Administration

Adult

IV: 2.5-5 mg slow push (over 2-3 minutes); may be repeated if necessary in small increments (total maximum not to exceed 0.1 mg/kg)

Pediatric

Not recommended.

Special Consideration

Pregnancy Safety: Category D

Administer immediately before the intubation procedure

Provide continuous monitoring of respiratory and cardiac function

Have resuscitation equipment and medication readily at hand.

Never administer as a rapid IV bolus