4/11/2023 0 Comments Midazolam antidoteTell your doctor or pharmacist right away if you have any withdrawal symptoms such as headaches, trouble sleeping, restlessness, hallucinations/confusion, depression, nausea, or seizures. To prevent withdrawal, your doctor may lower your dose slowly. Suddenly stopping this medication may cause serious (possibly fatal) withdrawal, especially if you have used it for a long time or in high doses. Get medical help right away if any of these very serious side effects occur: slow/shallow breathing, unusual lightheadedness, severe drowsiness/ dizziness, difficulty waking up. Be sure you know how to use midazolam and what other drugs you should avoid taking with it. To lower your risk, your doctor should have you use the smallest dose of midazolam that works, and use it for the shortest possible time. Using this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death. Midazolam has a risk for abuse and addiction, which can lead to overdose and death. Newborns must not be given midazolam by rapid injection because of the risk of very serious side effects. Lower doses of midazolam should be used if a patient is also receiving other medications that cause drowsiness. Lower doses should be used for these patients. Infants, children, older adults, or weak patients are more sensitive to the effects of midazolam. Midazolam must be used only under close medical supervision. The risk of serious breathing problems is higher with high doses or if midazolam is given too quickly into a vein. Initial dose in children six months to five years of age: 0.Giving midazolam by injection into a vein can sometimes cause severe breathing problems which could rarely lead to brain damage or be fatal. Titrate: 1 mg intravenously every three minutes Titrate: 1 mcg per kg every three minutes intravenouslyĬough, hiccup, itching, vomiting, respiratory depression, requires another agent for sedation, poor reliability, repeat dosing usually required † Initial dose in adults: 1 to 1.5 mcg per kg intravenouslyįamiliarity, availability, reversibility, proven safety record, minimal cardiovascular depression* Use in children younger than five years to counteract vagal effects of ketamine.* Nystagmus, hypersecretions, agitation, emergence delirium, vomiting, myoclonus, laryngospasm, cardiovascular stimulation, may require concurrent atropine sulfate in children younger than five years †Ĭontraindications: hypertension, ischemia, increased intracranial or intraocular pressure, active respiratory infection, psychosis, infants younger than three monthsĬhildren: 0.01 mg per kg intravenously/intramuscularly Sedation in children: 2 to 4 mg per kg intramuscularly Food and Drug Administration for children younger than 16 years* Reliable, established safety in children, intramuscular route, first-line agent in children not approved by the U.S. Sedation in children: 1 to 2 mg per kg intravenously Sedation in adults: 0.2 mg per kg over 30 to 60 secondsĪdvantages: single agent, reliable, no cardiovascular or respiratory depression, first-line agent in adultsĭisadvantages: limited data with PSAA, action too short for some procedures Use other alternatives when possible or necessary, such as topical or subcutaneous anesthetics, topical skin adhesives, or controlled physical restraint.Ĭonsider digital block or regional nerve block.Ĭonsider hematoma block,* digital block, or regional nerve block.Ĭonsider digital or regional nerve block.ĭebridement, significant pain, large surface area, severe burn Use if subcutaneous anesthesia is judged to beinadequate.Īcute, no suspected increase in intracranial pressureĬonsult with on-site radiologist or subspecialist when available, timing of procedural sedation and anesthesia with imaging is key.Īcute, concern for elevated intracranial pressureĭefer to preference of consulting radiologist or other subspecialist present at time of procedure.ĭefer to preference of consulting radiologist or other subspecialist present at time of procedure, consider mild oral anxiolytic. Use when suction, irrigation, or other physical measures have failed.
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