Pregnancy Classes

• Long-acting benzodiazepine binds to benzodiazepine receptors (GABA receptors) on neurons at several sites within the central nervous system.

• Treatment of seizures
• Treatment of severe agitation in behavioral and intoxication (e.g. cocaine, methamphetamine)

• Acute narrow-angle glaucoma
• Acute pulmonary insufficiency
• Severe chronic obstructive pulmonary disease
• Patients not sufficiently alert to respond appropriately to verbal requests
• Use with caution in patients with heart failure

Adult:

IV, IM: 2 to 10 mg every 3 to 10 minutes as needed

Pediatric:

IV: 0.2 mg/kg/dose, may repeat dose once in 5 minutes; maximum dose: 10 mg/dose

4-5 minutes

IM: 1 hour

IV: 3-5 minutes

12+ hours

• Monitoring: Monitor blood pressure, pulse and respiration continuously during administration. Oxygen and resuscitative equipment should be readily available.
• Oversedation: Midazolam has been associated with profound sedation, respiratory depression, and respiratory arrest. Airway obstruction, desaturation, hypoxia, and apnea have also been reported, most often when used concomitantly with other CNS depressants (eg, opioids).
• Kidney disease: Use with caution in kidney dysfunction and those on dialysis - the duration is prolonged.
• Liver disease: Use with caution in patients with hepatic impairment - the duration is prolonged.
• Paradoxical reactions: Paradoxical reactions, including hyperactive or aggressive behavior, have been reported with benzodiazepines.

• Cardiovascular
  • Bradycardia
  • Hypotension
  • Syncope
  • Vasodilation
• Central Nervous System
  • Agitation
  • Drowsiness
  • Headache
• Gastrointestinal
  • Vomiting
  • Diarrhea
• Respiratory
  • Asthma
  • Coughing
  • Hypoventilation