Oral transmucosal etomidate produces dose-related increases in sedation and clinically significant serum concentrations. Animal studies documented etomidate as highly permeable through the buccal mucosa with rapid onset and offset suggesting that oral transmucosal etomidate might be useful when brief mild to moderate sedation with rapid recovery is desirable. Oral transmucosal etomidate exhibited linear pharmacokinetics with […]
Some of the Ketamine effects discussed here. Ketamine does not increase the intraocular pressure (lOP) in routine analgesic doses. Even after the IM injection of 8 mg/kg, ketamine doses not raise lOP. However, in an: other study, in children anaesthetized with halothane, ketamine demonstrated a dose-dependent effect on lOP. A dose of 6 mg/kg IM
Benzodiazepines dependence may produce physical and psychological dependence after chronic (>6 months) use of commonly prescribed low-potency benzodiazepines. Withdrawal symptoms (irritability, insomnia, tremulousness) appear within 1 to 2 days for short-acting benzodiazepines dependence and within 2 to 5 days for longer-acting drugs. When administered to patients who have benzodiazepine induced CNS depression of benzodiazepines dependance, flumazenil produces rapid and dependable
For sedation prior to anesthesia or procedures, for longer and/or more stimulating procedures, midazolam IM can be used to facilitate insertion of an IV catheter for titration of additional medication. Midazolam IM doses of 0.1 to 0.15 mg/kg are usually effective and do not prolong emergence from general anesthesia. For more anxious patients, doses up
Midazolam IV is the first benzodiazepine that was produced primarily for use in anaesthesia. Walser and colleagues in 1976 “first described midazolam, the first clinically used water-soluble benzodiazepine. The imidazole ring in its structure accounts for its stability in aqueous solution and rapid metabolism. It is two to three times as potent as diazepam and
As a group, paediatric patients generally require higher doses of midazolam than do adults and younger children may require higher doses than older children. In obese individuals, the midazolam syrup dose should be calculated based on ideal body weight. Oral premedication: Oral midazolam syrup is effective for sedation and anxiolysis at the doses of 0.25—1
Reactions such as agitation, involuntary movements, hyperactivity and combativeness are usually reported during midazolam administration . Should such reactions occur, the response to each dose of midazolam and all other drugs, including local anesthetics, should be evaluated before proceeding with the midazolam administration of the drug. For induction of general anaesthesia in healthy patients, the
A syrup is effective for producing sedation and anxiolysis at a Midazolam oral dose of 0.25 mg/kg with minimal effect on ventilation even when administered at doses as large as 1 mg/kg. Midazolam oral is the most commonly used oral preoperative medication for children. Midazolam oral dose which is, 0.5 mg/kg given orally 30 minutes before
Based on the pharmacokinetic parameters and reported clinical experience in preterm and term midazolam in neonates , continuous IV infusion of midazolam should be initiated at a rate of 0.0005 to 0.001 mg/kg/mm (0.5 to 1 mcg/kg/min). IV loading doses should not be used with midazolam in neonates ; rather the infusion may be run
Diazepam IV is a highly lipid-soluble benzodiazepine with a more prolonged duration of action compared with midazolam. Diazepam IV is dissolved in organic solvents (propylene glycol, sodium benzoate) because it is insoluble in water. Dilution with water or saline causes cloudiness but does not alter the potency of the drug. Injection by either the IM
