Midazolam (Versed)

Classification:

Benzodiazepine.

       

Route

Onset of Action

Peak Effect

Duration of Action

IV

1 minute

          3-5 minutes

        15min. – 6hours

IM

5-15 minutes

15-60 minutes

2-6 hours

Oral

< 10 minutes

30 minutes

2-6 hours

  

Dosage / Administration 

  • Midazolam (Versed) is a very potent short acting drug that must be given slowly. I administration over at least two minutes is recommended.
  • Dilution: May dilute to desired concentration with D5W or Ns. Recommend concentration of 0.25 mg/ml, with administration rate no faster than 0.5 mg over 2 minutes.

 

Adult Dose:

Initial dose of 0.5mg IV over 2-minutes just before beginning of procedure. Must titrate to effect (slurred speech) by giving additional IV doses over 2 minutes. In general, do not exceed total dose of 3.0 mg,

  • You may continue to titrate higher doses if needed to obtain effect. Wait at least 2 minutes after each administration of medication to determine effect.

Geriatric or patients with impaired pulmonary/hepatic function:

  • Initial dose 0.25mg-0.5mg IV over 2 minutes. Maximum total dose is 2.0 mg. Titrate to effect.

Pediatric:

  • 0.025 – 0.05 mg/kg  IV over 2 minutes.  Maximum total dose 0.1 mg /kg. Titrate to effect.

 

 Contraindications:

  • Do not give midazolam to persons with known hypersensitivities to the drug.
  • Do not give to patients with acute narrow-angle glaucoma and shock.
  • Reduce dosage for patients with alcohol intoxication, or history of COPD.

 

Adverse Reactions:

  • Respiratory effects – Respiratory depression, apnea, coughing, bronchospasm

 

  • Cardiovascular effects – Cardiac arrest, hypotension, bradycardia, PVC's, Tachycardia

 

  • CNS effect – Urticaria

 

  • GI effects – Nausea, vomiting, uticaria, hiccups

 

  • Special Considerations – Pain at injection site.

 

Reversal:

Flumazenil (Romazicon) will reverse the respiratory effects of midazolam overdose.

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