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.