Midazolam

See critical care quick reference for drug doses by weight.

General

• Type: Benzodiazepines
• Dosage Forms: IV
• Common Trade Names: Versed

Adult Dosing

• Anxiolysis/sedation: 1-2mg IV push
• ICU Sedation:
  • Load: 10-50mcg/kg IV infusion
  • Maintenance: 20-100 mcg/kg/hr infusion
  • Use with standardized sedation protocol for titration

Pediatric Dosing

See critical care quick reference for drug doses by weight.

Special Populations

• Pregnancy Rating: D
  • Maternal use shortly before delivery associated with floppy infant syndrome
• Lactation: Distributed in breast milk, use with caution
• Renal Dosing:
  • Adult
  • Pediatric
• Hepatic Dosing:
  • Adult
  • Pediatric

Contraindications

• Allergy to class/drug

Adverse Reactions

Serious

• Apnea
• Hypopnea
• Hypotension
• Delirium, when used for prolonged periods in ICU setting

Common

• Drowsiness
• Nausea/vomiting

Pharmacology

• Half-life: 1.8-6.4 hr
• Metabolism: Metabolized in liver by CYP3A4 to active metabolite alpha1-hydroxymidazolam
• Excretion: Renal
• Mechanism of Action: CNS depressant. Acts at GABA receptor to increase frequency of chloride channel opening, causing hyperpolarization and stabilization of neuronal membrane.

See Also

• Intranasal sedation

Sources

Micromedex