Midazolam

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Midazolam Brand Names- Nayzilam | Versed

What is Midazolam

Midazolam is a short-acting benzodiazepine used for sedation, anxiolysis, and amnesia.

Parenteral and intranasal formulations are used for the acute treatment of seizures.

Parenteral midazolam is also used therapeutically in the management of agitation in mechanically ventilated patients in intensive care units, and to treat refractory status epilepticus.

Oral midazolam is useful in reducing anxiety and inducing sedation in children who would otherwise require intravenous sedation or general anesthesia to perform a medical or dental procedure.

FDA-approved labeling contains a black-box warning that describes the risk of profound sedation, respiratory depression, coma, and death with the concomitant use of opioids.

Indications

  1. acute repetitive seizures
  2. agitation
  3. alcohol withdrawal
  4. amnesia induction
  5. anxiety
  6. general anesthesia induction
  7. general anesthesia maintenance
  8. procedural sedation
  9. rapid-sequence intubation
  10. sedation maintenance
  11. status epilepticus

For procedural sedation and amnesia induction and to control preoperative anxiety

Side Effects

  1. agitation
  2. amnesia
  3. anaphylactoid reactions
  4. anxiety
  5. apnea
  6. ataxia
  7. blurred vision
  8. bradycardia
  9. bronchospasm
  10. cardiac arrest
  11. chills
  12. confusion
  13. cough
  14. delirium
  15. dental pain
  16. diplopia
  17. dizziness
  18. drowsiness
  19. dysarthria
  20. dysgeusia
  21. dysphonia
  22. dysphoria
  23. dyspnea
  24. emotional lability
  25. erythema
  26. euphoria
  27. excitability
  28. hallucinations
  29. headache
  30. hematoma
  31. hiccups
  32. hostility
  33. hyperreflexia
  34. hypersalivation
  35. hyperventilation
  36. hypotension
  37. hypoventilation
  38. hypoxia
  39. injection site reaction
  40. insomnia
  41. involuntary movements
  42. irritability
  43. lacrimation
  44. laryngospasm
  45. lethargy
  46. mania
  47. memory impairment
  48. myoclonia
  49. nasal irritation
  50. nausea
  51. nightmares
  52. nystagmus
  53. paresthesias
  54. phlebitis
  55. physiological dependence
  56. premature ventricular contractions (PVCs)
  57. pruritus
  58. psychological dependence
  59. psychosis
  60. rash
  61. respiratory arrest
  62. respiratory depression
  63. restlessness
  64. rhinorrhea
  65. seizures
  66. sinus tachycardia
  67. sneezing
  68. tachypnea
  69. throat irritation
  70. tolerance
  71. tremor
  72. urticaria
  73. vertigo
  74. visual impairment
  75. vomiting
  76. weakness
  77. wheezing
  78. withdrawal
  79. yawning

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • abrupt discontinuation
  • benzodiazepine dependence
  • benzodiazepine hypersensitivity
  • bipolar disorder
  • breast-feeding
  • cardiac disease
  • children
  • chronic obstructive pulmonary disease (COPD)
  • closed-angle glaucoma
  • CNS depression
  • coadministration with other CNS depressants
  • congenital heart disease
  • dehydration
  • dementia
  • depression
  • driving or operating machinery
  • electrolyte imbalance
  • epidural administration
  • ethanol ingestion
  • ethanol intoxication
  • extravasation
  • geriatric
  • heart failure
  • hepatic disease
  • hepatic encephalopathy
  • hypotension
  • hypovolemia
  • in utero exposure
  • infants
  • intraarterial administration
  • intrathecal administration
  • intravenous administration
  • labor
  • mania
  • neonates
  • obesity
  • obstetric delivery
  • pregnancy
  • premature neonates
  • psychosis
  • pulmonary disease
  • pulmonary hypertension
  • renal failure
  • renal impairment
  • requires a specialized care setting
  • requires an experienced clinician
  • respiratory depression
  • respiratory insufficiency
  • seizures
  • shock
  • sleep apnea
  • status asthmaticus
  • substance abuse
  • suicidal ideation

Interactions

  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dichloralphenazone; Isometheptene
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Pentazocine
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Tramadol
  • Acrivastine; Pseudoephedrine
  • Aldesleukin, IL-2
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  • Alprazolam
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  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
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  • Chlorpheniramine; Dextromethorphan
  • Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
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  • Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Dexmedetomidine
  • Dextromethorphan; Diphenhydramine; Phenylephrine
  • Dextromethorphan; Guaifenesin; Phenylephrine
  • Dicyclomine
  • Dienogest; Estradiol valerate
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Diltiazem
  • Dimenhydrinate
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  • food
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  • Glycerol Phenylbutyrate
  • grapefruit juice
  • Green Tea
  • Guaifenesin; Hydrocodone
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Phenylephrine
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