||anxiolytic agent; sedative; anticonvulsant
- used in the initial control of seizures or in the treatment of status epilepticus
- has no long-term anticonvulsant activity
- useful in the management of alcohol withdrawal and delirium tremens
- muscle relaxant - useful in patient with tetanus
- Loading Dose:
- <55 y.o. 2 - 2.5 mg IV direct
- >55 y.o. 1 - 1.5 mg IV direct
- (reduce the dose by 30% in patients premedicated with narcotics and CNS depressants)
- Maintenance Infusion:
- initiate at 1 - 5 mg/hr; titrate to individual response and to target VAMAAS (tolerance may occur)
- dosage reductions recommended in patients with CHF, septic shock, renal and/or hepatic dysfunction, low serum albumin, pulmonary insufficiency, COPD, or elderly patients
100 mg/50 mL D5W, NS for syringe pump infusion
- respiratory depression and partial airway obstruction, especially when combined with narcotics
- hypertension or hypotension
- headache, drowsiness, dizziness, excessive sedation
- amnesia, lack of recall
- opioids/inhalation anaesthetics + midazolam = increased or prolonged sedation
- arterial blood pressure
- respiratory rate
- response to sedation
- May be given IV direct by an approved nurse in CCTC.
- If ordered as a sedative/anxiolytic agent for a patient receiving mechanical ventilation, must be discontinued when mechanical ventilation ceases.
- May be continued IV direct post-ventilation if specifically ordered following assessment by physician.
- Continuous infusion must be admininstered by infusion pump.