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Midazolam

midazolam

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By Medicover Hospitals / 03 Mar 2021
Home | Medicine | Midazolam

What is Midazolam?

  • Midazolam is a benzodiazepine drug used for anesthesia, procedural sedation, difficulty sleeping, and extreme agitation. It is marketed under the brand names Versed and others. It works by making you tired, lowering your anxiety, and stopping you from making new memories.
    1. Midazolam Uses
    2. Midazolam Side effects
    3. Precautions
    4. Interactions
    5. Midazolam vs Lorazepam
    6. Frequently Asked Questions
    7. Citations

    Midazolam Uses:

  • This drug is administered to children before surgery or anesthesia to make them sleepy, alleviate anxiety, and make them forget about the procedure. It should be used when the child is under the control of a doctor. It is not intended for use at home or over a long period of time. Midazolam belongs to the benzodiazepine family of drugs, which have a calming effect on the brain and nerves (central nervous system). It is believed to function by improving the effects of a natural chemical in the brain called GABA.
  • How to use

    • Your dosage will be prepared and weighed by a healthcare professional. As instructed by your doctor, take this medicine by mouth. Before surgery or anesthesia, it is usually administered as a single dose.
    • The dosage is determined by your medical condition, therapy reaction, weight, and any other drugs you are taking.
    • Withdrawal symptoms (shaking, sweating, vomiting, abdominal/muscle cramps, seizures) may occur if you suddenly stop taking this drug. To avoid withdrawal, your doctor can gradually reduce your dosage. If you've been taking midazolam for a long time or in heavy doses, you're more likely to experience withdrawal symptoms. If you experience withdrawal symptoms, call your doctor or pharmacist right away.
    • Despite the fact that it benefits a large number of people, this drug has the ability to cause addiction. If you have a substance use disorder (such as overuse or addiction to drugs/alcohol), the risk could be higher. Do not take a higher dosage, take it more often, or use it for longer than recommended. If this drug isn't working as well as it used to, speak to your doctor. If the drug is to be discontinued, do so correctly.
    • Unless your doctor advises you otherwise, stop eating grapefruit or consuming grapefruit juice while taking this drug. Certain drugs can cause an increase in the amount of grapefruit in the bloodstream. For more details, speak to your doctor or pharmacist.

    Midazolam Side effects:

    • Aggressiveness
    • Agitation
    • Anxiety
    • Choking
    • Confusion
    • Decreased awareness or responsiveness
    • Decreased urine output
    • Difficulty walking, speaking, or writing
    • Discouragement
    • Dizziness
    • Feeling sad or empty
    • Fever
    • Headache
    • Irritability
    • Lack of appetite
    • Loss of bladder or bowel control
    • Loss of consciousness
    • Loss of interest or pleasure
    • Memory loss
    • Muscle twitching
    • Nausea
    • Nightmares or unusually vivid dreams
    • Rapid weight gain
    • Seizures
    • Severe sleepiness
    • Strong urge to urinate
    • Swelling of the face, ankles, or hands
    • Thirst
    • Trouble concentrating
    • Trouble sleeping
    • Troubled breathing
    • Unable to speak
    • Unusual drowsiness
    • Dullness
    • Tiredness
    • Weakness
    • Feeling of sluggishness
    • Allergic Reactions
    • Blurred Vision
    • Bruising and Bleeding
    • Constipation
    • Cough
    • Dehydration
    • Diarrhea
    • Drowsiness or Sedation
    • Dry mouth (Xerostomia)
    • Erectile Dysfunction or Decreased Sexual Desire
    • Esophageal Damage
    • Indigestion or Gastroesophageal Reflux Disease (GERD)
    • Falling or Unsteadiness on Feet
    • Gingival Enlargement (Growth of the gums around the teeth)
    • Gout
    • Headache
    • Infection
    • Hair Loss
    • Muscle Pain or Muscle Weakness
    • Nausea and Vomiting
    • Taste Disturbances
    • Tendonitis (tendinitis) or Tendon Rupture
    • Weight Gain

    Precautions:

    • Before taking this medicine, inform your doctor or pharmacist whether you have any of the following medical conditions: kidney disease, liver disease, respiratory disorders (e.g., COPD, sleep apnea), cardiac disease (e.g., congestive heart failure), glaucoma (open-angle), or a personal or family history of a substance use disorder (such as drug or alcohol abuse).
    • If you are allergic to midazolam or other benzodiazepines (e.g., diazepam), or if you have any other allergies, notify your doctor or pharmacist before taking it. Inactive ingredients (such as cherry flavouring) may be found in this product, triggering allergic reactions or other issues. For more information, talk with your pharmacist.
    • If you have any medical problems, you should not take this drug. If you have glaucoma, speak to your doctor or pharmacist before taking this drug (narrow-angle).
    • Tell your doctor or pharmacist about your medical history, particularly if you have kidney disease, liver disease, or breathing difficulties (e.g., chronic obstructive pulmonary disease).
    • This medication can cause dizziness or drowsiness. You can feel dizzy or sleepy if you ingest alcohol or marijuana (cannabis). Do not drive, operate machinery, or engage in any other operation that involves alertness until you are confident you can do so safely. Alcoholic drinks should be avoided. If you use marijuana, talk to your doctor (cannabis).
    • Inform the doctor or dentist that you are taking this drug before having surgery.
    • Infants and children under the age of three who are given anesthesia or sedative drugs (including midazolam) for procedures/surgeries may experience slower brain development. Discuss the dangers and benefits of this drug with your doctor.
    • It is not advisable to take this drug while pregnant. It has the ability to injure an unborn child. Irritability, abnormal/consistent crying, vomiting, and diarrhea have all been recorded in babies born to mothers who took similar drugs for a long time. For more facts, speak to your doctor.
    • This medicine is excreted in breast milk. Before you start breastfeeding, talk to your doctor.

    Interactions:

  • Drug interactions can cause your drugs to function differently or put you at risk for severe side effects. This list does not cover all potential drug interactions. Keep a list of all you use (including prescription and nonprescription medications, as well as herbal products) and share it with your doctor and pharmacist. Without your doctor's permission, do not begin, stop, or change the dosage of any medications.
  • Delavirdine, HIV protease inhibitors (e.g., ritonavir, saquinavir, atazanavir), and sodium oxybate are some of the products that may interact with this drug.
  • Midazolam vs Lorazepam:

    Midazolam
    Lorazepam
    Brand name Versed Brand name Ativan
    Used for anesthesia, procedural sedation, difficulty sleeping, and extreme agitation Used to manage anxiety disorders, for the short-term relief of symptoms of anxiety
    Molecular Formula: C18H13ClFN3 Formula: C15H10Cl2N2O2
    Molecular Weight: 325.8 g/mol Molar mass: 321.2 g/mol

    Frequently Asked Questions:

    Midazolam injections are used to induce drowsiness, relieve anxiety, and prevent memory loss during medical procedures and surgery. It's also sometimes used as part of a surgical anesthetic to induce a state of unconsciousness.
    Common side effects are - Nausea, vomiting, dizziness, or drowsiness, mental/mood changes, shaking/tremor, slow/fast heartbeat, blurred vision.
    Using other drugs that make you sleepy or slow your breathing soon after you've been treated with midazolam can result in dangerous side effects or death. Before taking an opioid medication, a sleeping pill, a muscle relaxant, or medicine for anxiety or seizures, consult your doctor.
    Versed (midazolam) is a benzodiazepine, a form of medication that induces drowsiness, relaxation, and partial or complete memory loss when taken. It's also used to help you tolerate a medical procedure better.
    Midazolam can be delivered orally, intravenously, or intramuscularly, or sprayed into the nose or cheek. It normally starts working in five minutes when administered intravenously, but it can take up to fifteen minutes when injected into a muscle. The effects last anywhere from one to six hours.
    Sedation with midazolam is used before diagnostic and therapeutic medical procedures. It's an imidazole benzodiazepine that depresses the central nervous system (CNS) with a fast onset of action and few side effects.
    Midazolam is a strong sedative that involves thorough administration and dose personalization. Midazolam is 3 to 4 times more active per mg than diazepam in clinical trials.
    Midazolam does not boost pain regulation as an alternative to morphine in the prehospital treatment of trauma-induced pain, according to our results. Midazolam use, on the other hand, tends to be related to an improvement in drowsiness.
    Midazolam is an extremely useful and safe drug for both inpatients and outpatients when used with caution, proper patient monitoring, and gradual, precise titration to the desired effect.
    While midazolam induced anterograde amnesia, no evidence of retrograde amnesia has been found. After laparoscopic cholecystectomy, a patient developed profound amnesia, both anterograde and retrograde. After IV injections of the benzodiazepine antagonist flumazenil, the patient's memory was restored.

    Citations:

  • Midazolam,https://link.springer.com/content/pdf/10.2165/00003495-198428060-00002.pdf
  • Midazolam Uses, https://pubs.asahq.org/anesthesiology/article-pdf/62/3/310/309390/0000542-198503000-00017.pdf