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Midazolam - Versed - PDF

This document provides guidelines for the use of midazolam (Versed) in neonates, including recommended dosing for sedation and as an anticonvulsant. It lists the chief indications as sedation during mechanical ventilation or procedures and treatment of refractory seizures. Potential adverse reactions include respiratory depression, hypotension, and CNS depression. Nursing implications are to monitor the infant's respiratory status, blood pressure, sedation level and to assess for pain as midazolam provides no pain relief. An antidote of flumazenil is also noted.

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Ahmad Abqari
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154 views

Midazolam - Versed - PDF

This document provides guidelines for the use of midazolam (Versed) in neonates, including recommended dosing for sedation and as an anticonvulsant. It lists the chief indications as sedation during mechanical ventilation or procedures and treatment of refractory seizures. Potential adverse reactions include respiratory depression, hypotension, and CNS depression. Nursing implications are to monitor the infant's respiratory status, blood pressure, sedation level and to assess for pain as midazolam provides no pain relief. An antidote of flumazenil is also noted.

Uploaded by

Ahmad Abqari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Guidelines for the Use of MIDAZOLAM (Versed )

Recommended Neonatal Dose, Route, and Interval

A. Sedation:

- Intermittent IV boluses: 0.05 - 0.15 mg/kg/dose IV push over at least 5 minutes. Repeat
every 2-4 hours prn. May also be given IM.
- Continuous IV infusion: 0.01-0.06 mg/kg/hour (10 to 60 mcg/kg/hour), titrate to effect.
- Oral: 0.25 mg/kg per dose using versed oral syrup

B. Anticonvulsant:

- Loading dose: 0.15 mg/kg (150 mcg/kg) IV given over at least 5 minutes , followed by
- Maintenance infusion: 0.06 to 0.4 mg/kg per hour (1 to 7 mcg/kg/minute)

Chief Indications

Sedation during mechanical ventilation / procedures


Treatment of refractory seizures

Possible Adverse Reactions:

1. Respiratory depression and respiratory arrest (particularly with excessive doses or rapid IV
infusions)
2. Hiccoughs, CNS depression, myoclonic jerks
3. Hypotension, bradycardia
4. Antidote: Flumazenil 0.01 mg/kg/dose IV push. May repeat every minute for up to 4 more
doses.

Contraindications & Precautions

Hypersensitivity to midazolam. May see cross-sensitivity with other benzodiazepines.


CNS depression, uncontrolled pain, severe hypotension
Abrupt discontinuation after prolonged use may precipitate withdrawal or seizures.
Rapid IV injection may result in hypotension, respiratory depression or seizures.

Nursing Implications
Midazolam provides no pain relief. Agitation may be due to pain and infant should be assessed
for need of pain medication.
Monitor respiratory status, blood pressure, and level of sedation.
Onset of sedation: PO within 10-20 minutes, IM within 5 minutes, IV within 1-5 minutes
Peak sedation: IM 15-30 minutes, IV 5-7 minutes

References:
1. Neofax 2010
Reviewed/Revised: 6/2010 by

Samir Alabsi, MD
Kelli DeVore, Pharm. D, BCPS
Rebecca Willson, ARNP, NNP

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