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Acute use (1–3 days) yields a potency about 1.5× stronger than that of morphine and chronic use (7 days+) yields a potency about 2.5 to 5× that of morphine. Similarly, the effect of tramadol increases after consecutive dosing due to the accumulation of its active metabolite and an increase of the oral bioavailability in chronic use.
Midazolam is known to cause respiratory depression. In healthy humans, 0.15 mg/kg of midazolam may cause respiratory depression, which is postulated to be a central nervous system (CNS) effect. [48] When midazolam is administered in combination with fentanyl, the incidence of hypoxemia or apnea becomes more likely. [49]
The tables below contain a sample list of benzodiazepines and benzodiazepine analogs that are commonly prescribed, with their basic pharmacological characteristics, such as half-life and equivalent doses to other benzodiazepines, also listed, along with their trade names and primary uses.
Midazolam 1 & 5 mg/mL injections (Canada). Benzodiazepines possess psycholeptic, sedative, hypnotic, anxiolytic, anticonvulsant, muscle relaxant, and amnesic actions, [4] [5] which are useful in a variety of indications such as alcohol dependence, seizures, anxiety disorders, panic, agitation, and insomnia.
However, combinations of high doses of benzodiazepines with alcohol, barbiturates, opioids or tricyclic antidepressants are particularly dangerous, and may lead to severe complications such as coma or death. In 2013, benzodiazepines were involved in 31% of the estimated 22,767 deaths from prescription drug overdose in the United States. [5]
A box of Lorazepam Orion (Lorazepam) tablets. Lorazepam, sold under the brand name Ativan among others, is a benzodiazepine medication. [15] It is used to treat anxiety (including anxiety disorders), insomnia (trouble sleeping), severe agitation, active seizures including status epilepticus, alcohol withdrawal, and chemotherapy-induced nausea and vomiting. [15]
The procedure is to take the child's weight in pounds, divide by 150 lb, and multiply the fractional result by the adult dose to find the equivalent child dosage.For example, if an adult dose of medication calls for 30 mg and the child weighs 30 lb, divide the weight by 150 (30/150) to obtain 1/5 and multiply 1/5 times 30 mg to get 6 mg.
The consensus is to reduce dosage gradually over several weeks, e.g. 4 or more weeks for diazepam doses over 30 mg/day, [1] with the rate determined by the person's ability to tolerate symptoms. [120] The recommended reduction rates range from 50% of the initial dose every week or so, [121] to 10–25% of the daily dose every 2 weeks. [120]