Midazolam
 
Presentation
 • 5mg in 1ml amp
• 15mg in 3ml amp
Pharmacology
 • Short acting CNS depressant
Actions
 • Anxiolytic, reducing anxiety
• Sedative
• Anti-convulsant
Metabolism
 • In the liver
• Excreted by the kidneys
Primary Emergency Indications

• Continuous/recurrent seizures Adult Paed
 • Intubation Factilitated by Sedation Adult Paed
• Rapid Sequence Intubation Adult
• Post Intubation Sedation following:
   - Unassisted Intubation Adult Paed
   - Intubation Facilitated by Sedation Adult Paed
   - Rapid Sequence Intubation Adult
• Sedation to enable synchronized cardioversion Adult
• Sedation in the agitated Pt Adult
• Sedation in psychostimulant overdose Adult Paed
• Convulsions associated with Lignocaine toxicity Adult  Paed
Contraindications
 • Known hypersensitivity to benzodiazepines
Precautions
 • Reduced doses may be required for the elderly, Pts with chronic renal failure, congestive cardiac failure or shock
• The CNS depressant effects of benzodiazepines are enhanced in the presence of narcotics and other tranquillisers including alcohol
• Can cause severe respiratory depression in Pts with COPD
• Pts with myasthenia gravis
Route of Administration
 • IM
• IV
Side Effects
 • Depressed level of consciousness
• Respiratory depression
• Loss of airway control
• Hypotension
Special Notes
 • Midazolam is not permitted for use to facilitate the transport of Pts who have been recommended for transport under the Mental Health Act. If sedation is required in these circumstances then the Act requires that this only be administered by a prescribed Medical Practitioner or Registered Nurse.
Therapeutic Effect
IM     
Onset:
3-5min
Peak:
15min
Duration:
30min
 
IV     
Onset:
1-3min
Peak:
10min
Duration:
20min
Reference Dilutions
Morphine & Midazolam Infusion (Adult)
Morphine & Midazolam Infusion (Paed)
Midazolam Bolus (Paed)