Midazolam
Midazolam is a very short-acting parenteral benzodiazepine. Midazolam is used intramuscularly or intravenously for conscious sedation during minor surgical or diagnostic procedures, as an inducing agent, or as an adjunct to regional anesthesia. It was originally thought to be preferable to other benzodiazepines for conscious sedation because of its potency and its short duration of action, however, comparisons with diazepam, an agent with a much longer half-life, have not revealed a consistent advantage of it. It received FDA approval in December 1985. It can produce any level of CNS depression required including sedation, hypnosis, skeletal muscle relaxation, or anticonvulsant activity. The action of Midazolam is mediated through the inhibitory neurotransmitter gamma-aminobutyric acid (GABA). Midazolam is also used in the treatment of anxiety and seizures.
Primary Characteristics
It is of Synthetic origin and belongs to Benzodiazepine.
It belongs to Chloride Channel Potentiater (GABA operated) pharmacological group on the basis of mechanism of action and also classified in Benzodiazepine pharmacological group. It is also classified under General Anesthetics .
Molecular Weight: 325.8 · pKa: 6.2 · Solubility in Water: Soluble · Non-proprietary name: Midazolam.
Pharmacokinetics
Absorption: Midazolam has an oral bioavailability is 100%, pre-systemic (first-pass) metabolism accounts for 50%.
Distribution: Midazolam has a volume of distribution is 5.3 l/kg. plasma protein binding is 96 %.
Elimination: it is metabolised via extensive by Liver, plasma half-life is 2-7 hr, renal excretion is 1 %.
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Indications
Midazolam is primarily indicated in conditions like All forms of epilepsy, Anxiety, Induction of anaesthesia, Insomnia, Myoclonus, Sedation of patients receiving intensive care, Sedation with amnesia, Sedative in combined anaesthesia, Status epilepticus (unlicensed use).
Midazolam is also indicated for secondary conditions like Anesthesia, Surgery.
Contraindications
Midazolam is contraindicated in conditions like Respiratory insufficiency.
Dosage
Midazolam's dosage details are as follows:
| Dose | Single Dose | Frequency | Route | Instructions |
|---|---|---|---|---|
| Adult Dosage | ||||
| 2 mg | 2 mg | — | IV | Initial dose over 30 sec. followed after 2 min. by increments of 0.5 -1 mg, usual range 2.5-7.5mg |
| Paediatric Dosage (20kg) | ||||
| 0 – 0 | — | — | Not recommended for this age group | |
| Neonatal Dosage (3kg) | ||||
| 0 – 0 | — | — | Not recommended in this age group | |
Drug Interactions
Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Side Effects
The signs and symptoms that are produced after acute overdosage of Midazolam are Coma, Confusion , Impaired impulse conduction, Sedation , Somnolence, Impaired coordination , Loss of reflexes.
Midazolam is known to cause more or less tolerable side effects which are usually transient. These include Agitation , Blurred vision, Confusion, Drowsiness, Erythema, Headache, Hiccups, Induration , Involuntry muscle movements, Muscle rigidity, Nausea and vomiting, Pain , Pruritis, Rashes , Slurred speech, Somnolence , Tenderness , Thrombophlebitis .
Warnings / Precautions
Interference in Pathology
Midazolam may interfere in the diagnosis of interfere with clinical laboratory tests results.
Available Brands
Storage Conditions
Drug Classification
- 1.24.3 — Drugs used in anxiety and sleep disorders