What is Midazolam?

• A benzodiazepine often used as a co-induction agent to provide amnestic and anxiolytic properties.

Mechanism of Action & Pharmacokinetics ¹²

• Facilitates the inhibitory actions of the neurotransmitter GABA by increasing the frequency of chloride channel opening.
• Acts on glycine receptors to produce a muscle-relaxing effect.
• Has few systemic effects.

Pharmacodynamics ^{1 2}

Cardiovascular

• Minimally impacts blood pressure by reducing it through reduction of cardiac output and peripheral vascular resistance.
• Can have slight increase in heart rate.

  Respiratory

• When co-administered with respiratory depressants or administered intravenously, apnea or severe respiratory depression can occur.

  Central Nervous System

• Decreases cerebral metabolic rate
• Decreases cerebral blood flow
• Has anticonvulsant properties

Indications ¹

Anesthetic Indications

• May be used for Induction of General AnesthesiaInduction of General Anesthesia
  Introduction
  The start of a case represents one of the highest risk periods in the operation.
  
  After a surgical time-out, the tools required for a safe induction can be remembered with the MDSOLES ...
• Used for anxiolysis

Other Indications

• Treatment of seizure disorders
• Treatment of alcohol withdrawal
• Treat seizures secondary to local anesthetic toxicity

Dosage ¹

• 1-2 mg IV for sedation and co-induction
• Onset of action within 1 - 2 minutes
• Half-life of elimination = 1.5 - 2.5 hours

Complications ^{1 2}

• Amnesia
• Decreased level of consciousness
• Delirium (especially in the elderly)

References