Ver el código de «Midazolam»

''See [[critical care quick reference]] for drug doses by weight.''
==General==
*Type: [[Has DrugClass::Benzodiazepines]]
*Dosage Forms: IV
*Common Trade Names: Versed

==Adult Dosing==
*Anxiolysis/sedation:
**1-2mg IV push
**0.07 to 0.08 mg/kg IM, usual dose 5 mg for 60 kg pt
*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.''
*Anxiolysis/sedation:
**6mo-5yr: 0.05-0.1 mg/kg IV push
**6-12yr: 0.025-0.05 mg/kg IV push

*Intranasal
**Seizure: 0.2 mg/kg IN divided between nostrils
**Procedural sedation: 0.2-0.6 mg/kg IN divided between nostrils
**Anxiolysis: 0.5 mg/kg IN (max dose 10 mg)

==Special Populations==
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D
**Maternal use shortly before delivery associated with floppy infant syndrome
*Lactation: Distributed in breast milk, use with caution
*Renal Dosing:
**Adult: Decrease by 50% for severe renal failure
**Pediatric
*Hepatic Dosing: 
**Adult: Prolonged clearance in cirrhosis
**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==
*Peak effect: 
**IM: Children: 15 to 30 minutes; Adults: 30 to 60 minutes
**IV: 5 to 7 minutes
**Intranasal: 10 minutes
*Duration
**IV: Single dose: <2 hours (dose-dependent),up to 6 hours with cirrhosis
**IM: Up to 6 hours; Mean: 2 hours
**Intranasal: Children: 18 to 41 minutes
*Half-life: 1.8-6.4 hr 
*Metabolism: Metabolized in liver by CYP3A4 to active metabolite α<sub>1</sub>-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]]

==References==
Micromedex
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[[Category:Pharmacology]]