Midazolam

Trade Names: Versed

Class: Sedative, Anticonvulsant, Hypnotic
Pharmacology:

Onset: 3-5 min IV 15 min IM
Duration: <2 hr IV 1-6 hr IM

Binds to specific sites on the GABA Type A receptors and potentiate the effects of the GABA on the brain. Higher levels of GABA cause hypnotic and sedation effects
Indications:

Premedication for Cardioversion
Premedication for other painful procedures
Seizures

Contraindications:

Known Hypersensitivity
Narrow Angle Glaucoma
Shock
Depressed Vital Signs
Alcoholic Coma

Cautions:

Flumazenil must be Available
May be Accentuated by CNS Depressants

Side Effects:

Laryngospasm
Bronchospasm
Respiratory Depression and Arrest
Drowsiness
Amnesia
Altered Mental Status
Bradycardia
Tachycardia
PVC’s
Retching

Administration:
  • Adult Sedation: Typically 1-2.5 mg Slow IV 0.07-0.08 mg/kg IM
  • Adult Anticonvulsant: >2.5 mg IV 10 mg IM
Special Considerations:

Pregnancy Safety: Category D
Emergency Resuscitative Equipment must be Available
Flumazenil must be Available
Dilute with NS or D5W prior to administration