Midazolam: pharmacology and uses

Midazolam is an imidazobenzodiazepine with unique properties when compared with other benzodiazepines. It is water soluble in its acid formulation but is highly lipid soluble in vivo. Midazolam also has a relatively rapid onset of action and high metabolic clearance when compared with other benzodia...

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Bibliographic Details
Published in:Anesthesiology (Philadelphia) 1985-03, Vol.62 (3), p.310-324
Main Authors: REVES, J. G, FRAGEN, R. J, VINIK, H. R, GREENBLATT, D. J
Format: Article
Language:English
Subjects:
Adult
Aged
Aging
Ambulatory Surgical Procedures
Anesthetics
Animals
Benzodiazepines - administration & dosage
Benzodiazepines - adverse effects
Benzodiazepines - antagonists & inhibitors
Benzodiazepines - metabolism
Benzodiazepines - pharmacology
Benzodiazepinones - pharmacology
Biological and medical sciences
Biotransformation
Brain - drug effects
Chemical Phenomena
Chemistry
Female
Flumazenil
Hemodynamics - drug effects
Humans
Hypnotics and Sedatives
Hypnotics. Sedatives
Hypoxia, Brain - prevention & control
Injections, Intravenous
Kinetics
Male
Medical sciences
Midazolam
Middle Aged
Nausea - chemically induced
Neuropharmacology
Pharmacology. Drug treatments
Preanesthetic Medication
Psychology. Psychoanalysis. Psychiatry
Psychopharmacology
Respiration - drug effects
Sex Factors
Thrombophlebitis - chemically induced
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Summary:Midazolam is an imidazobenzodiazepine with unique properties when compared with other benzodiazepines. It is water soluble in its acid formulation but is highly lipid soluble in vivo. Midazolam also has a relatively rapid onset of action and high metabolic clearance when compared with other benzodiazepines. The drug produces reliable hypnosis, amnesia, and antianxiety effects when administered orally, intramuscularly, or intravenously. There are many uses for midazolam in the perioperative period including premedication, anesthesia induction and maintenance, and sedation for diagnostic and therapeutic procedures. Midazolam is preferable to diazepam in many clinical situations because of its rapid, nonpainful induction and lack of venous irritation. Compared with thiopental, midazolam is not as rapid acting nor predictable in hypnotic effect. It will not replace thiopental as an induction agent. Advantages of midazolam over thiopental are those of the more versatile pharmacologic properties of a benzodiazepine compared with a barbiturate such as amnestic and anxiolytic properties. Midazolam should be a useful addition to the formulary.
ISSN:0003-3022
1528-1175
DOI:10.1097/00000542-198503000-00017