Drug Information

   


             












Pharmacokinetics



It is rapidly absorbed following intramuscular administration with more
than 90% bioavailability.

          
Indication
& Dosage


 


IM

FOR PRE-OPERATIVE SEDATIN/ANXILYSIS/AMNESIA AND/OR PRIOR TO OR DURING
DIAGNOSTIC, THERAPEUTIC OR ENDOSCOPIC PROCEDURES, SUCH AS BRONCHOSCOPY,
GASTROSCOPY, CYSTOSCOPY, CARDIAC, ONCOLOGY, RADIOLOGICAL AND OTHER
SUPERFICIAL OR SURGICAL PROCEDURE:
  Adults: Below 60 year:
0.07-0.08mg/kg administered upto 1hour. Above 60 year: 0.02-0.05mg/kg 1
hour. Children: 0.1-0.15mg/kg. Max. total dose: 10mg.




IV

FOR PREOPERATIVE SEDATION/ ANXIOLYSIS/ AMNESIA AND/OR PRIOR TO OR DURING
DIAGNOSTIC, THERAPEUTIC OR ENDOSCOPIC PROCEDURES SUCH AS BRONCHOSCOPY,
GASTROSCOPY, CYTOSCOPY, CARDIAC, ONCOLOGY, RADIOLOGICAL, AND OTHER
SUPERFICIAL OR SURGICAL PROCEDURES: 
Adult: Patients below 60year
1-2.5mg. At a time adminster 2.5mg only. Maintenace: Increments of 25%
of doses to be given after thorouhg clinical evalutation. Max.
5mg. 

Children: below 6 months: to be administered at small increments with
careful monitoring; 6 months-5 year: 0.05mg/kg. Max. 0.6mg/kg; 6-12
years: 0.025mg/kg. Max. 0.4mg/kg; 12-16 years: 1-2.5mg. Max: 10mg.

Maintainence: Increments of 25% of doses are given after through
clinical evaluation.

FOR INDUCTION OF ANAESTHESIA: Adults: above 55 year: 0.3mg/kg; below 55
years: 0.3-0.35mg/kg. Administered for 20-30 secods, allowed for 2
minutes for effect. Maintenace: increments with careful monitoring; 6
months-5 years: 0.05-0.1mg/kg. Max. 0.6mg/kg; 6-12 years:
0.025-0.05mg/kg; 12-16 yrears: 1-2.5mg. Max: 10mg.

FOR SEDATION OF INTUABTED AND MECHANICALLY VENTILATED PATIENTS AS A
COMPONENT OF ANAESTHESIA DURING TREATMENT IN CRITICAL CARE SETTING
(CONTINUOUS INFUSION): Adult: 0.01-0.5mg/kg initially, infused over
several minutes. For adequate sedation, doses repeated at 10-15 minutes
intervals. Maintenance: Initially 0.02-0.1mg/kg/hour. 

Children: initial loading dose of 0.05-0.2mg/kg/hours;

Neonates above 32 weeks: 0.06mg/kg/hour. If premedicated with opioids
debilitation and neonates, the dose should be adjusted appropriately.


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Action

 


Midazolam is a short acting benzdiazepine with rapid onset of
action, recovery, and nonpainful induction and lack of venous
irritation. It exerts sedative and hypnotic, muscle relaxant, anxiolytic
and anticonvulsant actions. While the probable anxiolytic action might
be as a result of the drugs ability to increase glycine inhibitoroy
neurotransmitter level, the hypnotic/ anaesthetic action may be due the
occupation of hte benzodiazephine and GABA receptors leading to membrane
hyperpolarisation and neuronal inhibition, and further interfering with
the reuptake of GABA at the synapses.


TOP



   

Interactions

 


Anaesthetics (inhalation): Inhalation anaesthetics may need to be
reduced if midazolam is used as induction agent I.V.

Azole antifugal agents: Enhanced CNS depressionand prolnged effects.

CNS depressants: May increase risk of hypoventilation and contribute to
prolonged effect.

Ethanol: Increased CNS effects with acute ethanol ingestion.

Oral contraceptives: May result in prolongationof midazolam half life.

Rifamycin: Increase in midazolam & metabolite clearance &
decrease in elimination half life. 

Theophylline: Sedative effect of midazolam may be antagonised.

Thiopental: A reduction in induction dosage requirement of thiopental.

Verapamil: May produce increased cns depression and porlonged effects.


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Adverse
Effect & Precaution




Local effects like redness and phlebitis, apnoea(usually seen on iv
administration). Rarely nausea, vomiting, headache, drowsiness, hiccups
and retograde amnesia may occur.



Precaution: Patient should not operate motor vehicles or hazardous
machinery, impaired renal function patients. Concomitant administration
of alcohol, barbiturates and other CNS depressants should be avoided.

Pregnancy: Contraindicated.

Breast Feeding: COntraindicated.

Man: May be given in reduced dose.


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Brand
available in market


 




















FULSED

Ranbaxy
INJ 5mg/ml 1ml 30.00
INJ 1mg/ml 5mlvial 31.40
INJ 1mg/ml 10ml 52.80
MEZOLAM

Neon
INJ 1mg/ml 1mgx5ml 29.70
INJ 5mg/ml 5mgx1ml 288.00
INJ 1mg/ml 1mgx10 57.80
MIDOSED

Inca
INJ 1mg/ml 5x5ml 105.00
INJ 5mg/ml 5x10ml 140.00
SHORTAL

Themis
INJ 1mg/ml 1mgx5ml 20.70
INJ 5mg/ml 5mgx1ml 19.80





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Drug Information
   

             

Pharmacokinetics

It is rapidly absorbed following intramuscular administration with more than 90% bioavailability.
          

Indication & Dosage
 
IM
FOR PRE-OPERATIVE SEDATIN/ANXILYSIS/AMNESIA AND/OR PRIOR TO OR DURING DIAGNOSTIC, THERAPEUTIC OR ENDOSCOPIC PROCEDURES, SUCH AS BRONCHOSCOPY, GASTROSCOPY, CYSTOSCOPY, CARDIAC, ONCOLOGY, RADIOLOGICAL AND OTHER SUPERFICIAL OR SURGICAL PROCEDURE:
  Adults: Below 60 year: 0.07-0.08mg/kg administered upto 1hour. Above 60 year: 0.02-0.05mg/kg 1 hour. Children: 0.1-0.15mg/kg. Max. total dose: 10mg.

IV
FOR PREOPERATIVE SEDATION/ ANXIOLYSIS/ AMNESIA AND/OR PRIOR TO OR DURING DIAGNOSTIC, THERAPEUTIC OR ENDOSCOPIC PROCEDURES SUCH AS BRONCHOSCOPY, GASTROSCOPY, CYTOSCOPY, CARDIAC, ONCOLOGY, RADIOLOGICAL, AND OTHER SUPERFICIAL OR SURGICAL PROCEDURES: 
Adult: Patients below 60year 1-2.5mg. At a time adminster 2.5mg only. Maintenace: Increments of 25% of doses to be given after thorouhg clinical evalutation. Max. 5mg. 
Children: below 6 months: to be administered at small increments with careful monitoring; 6 months-5 year: 0.05mg/kg. Max. 0.6mg/kg; 6-12 years: 0.025mg/kg. Max. 0.4mg/kg; 12-16 years: 1-2.5mg. Max: 10mg.
Maintainence: Increments of 25% of doses are given after through clinical evaluation.
FOR INDUCTION OF ANAESTHESIA: Adults: above 55 year: 0.3mg/kg; below 55 years: 0.3-0.35mg/kg. Administered for 20-30 secods, allowed for 2 minutes for effect. Maintenace: increments with careful monitoring; 6 months-5 years: 0.05-0.1mg/kg. Max. 0.6mg/kg; 6-12 years: 0.025-0.05mg/kg; 12-16 yrears: 1-2.5mg. Max: 10mg.
FOR SEDATION OF INTUABTED AND MECHANICALLY VENTILATED PATIENTS AS A COMPONENT OF ANAESTHESIA DURING TREATMENT IN CRITICAL CARE SETTING (CONTINUOUS INFUSION): Adult: 0.01-0.5mg/kg initially, infused over several minutes. For adequate sedation, doses repeated at 10-15 minutes intervals. Maintenance: Initially 0.02-0.1mg/kg/hour. 
Children: initial loading dose of 0.05-0.2mg/kg/hours;
Neonates above 32 weeks: 0.06mg/kg/hour. If premedicated with opioids debilitation and neonates, the dose should be adjusted appropriately.

TOP
   

Action
 

Midazolam is a short acting benzdiazepine with rapid onset of action, recovery, and nonpainful induction and lack of venous irritation. It exerts sedative and hypnotic, muscle relaxant, anxiolytic and anticonvulsant actions. While the probable anxiolytic action might be as a result of the drugs ability to increase glycine inhibitoroy neurotransmitter level, the hypnotic/ anaesthetic action may be due the occupation of hte benzodiazephine and GABA receptors leading to membrane hyperpolarisation and neuronal inhibition, and further interfering with the reuptake of GABA at the synapses.

TOP
   

Interactions
 

Anaesthetics (inhalation): Inhalation anaesthetics may need to be reduced if midazolam is used as induction agent I.V.
Azole antifugal agents: Enhanced CNS depressionand prolnged effects.
CNS depressants: May increase risk of hypoventilation and contribute to prolonged effect.
Ethanol: Increased CNS effects with acute ethanol ingestion.
Oral contraceptives: May result in prolongationof midazolam half life.
Rifamycin: Increase in midazolam & metabolite clearance & decrease in elimination half life. 
Theophylline: Sedative effect of midazolam may be antagonised.
Thiopental: A reduction in induction dosage requirement of thiopental.
Verapamil: May produce increased cns depression and porlonged effects.

TOP
   

Adverse Effect & Precaution

Local effects like redness and phlebitis, apnoea(usually seen on iv administration). Rarely nausea, vomiting, headache, drowsiness, hiccups and retograde amnesia may occur.

Precaution: Patient should not operate motor vehicles or hazardous machinery, impaired renal function patients. Concomitant administration of alcohol, barbiturates and other CNS depressants should be avoided.
Pregnancy: Contraindicated.
Breast Feeding: COntraindicated.
Man: May be given in reduced dose.

TOP
     

FULSED

Ranbaxy

INJ

5mg/ml

1ml

30.00

INJ

1mg/ml

5mlvial

31.40

INJ

1mg/ml

10ml

52.80

MEZOLAM

Neon

INJ

1mg/ml

1mgx5ml

29.70

INJ

5mg/ml

5mgx1ml

288.00

INJ

1mg/ml

1mgx10

57.80

MIDOSED

Inca

INJ

1mg/ml

5x5ml

105.00

INJ

5mg/ml

5x10ml

140.00

SHORTAL

Themis

INJ

1mg/ml

1mgx5ml

20.70

INJ

5mg/ml

5mgx1ml

19.80

TOP
 
 

 

By |2022-07-20T16:42:54+00:00July 20, 2022|Uncategorized|Comments Off on Midazolam

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