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A benefit of midazolam is that in children it can be given in the cheek or in the nose for acute seizures, including status epilepticus. [ 22 ] [ 23 ] Drawbacks include a high degree of breakthrough seizures—due to the short half-life of midazolam—in over 50% of people treated, as well as treatment failure in 14–18% of people with ...
Midazolam is the most commonly prescribed for this use because of its strong sedative actions and fast recovery time, as well as its water solubility, which reduces pain upon injection. Diazepam and lorazepam are sometimes used. Lorazepam has particularly marked amnesic properties that may make it more effective when amnesia is the desired effect.
The WHO Model List of Essential Medicines for Children (aka Essential Medicines List for Children [1] or EMLc [1]), published by the World Health Organization (WHO), contains the medications considered to be most effective and safe in children up to twelve years of age to meet the most important needs in a health system.
Sedation scales are used in medical situations in conjunction with a medical history in assessing the applicable degree of sedation in patients in order to avoid under-sedation (the patient risks experiencing pain or distress) and over-sedation (the patient risks side effects such as suppression of breathing, which might lead to death).
The most commonly utilized benzodiazepine is Midazolam, which is characterized by a rapid onset and short duration. Midazolam is effective in reducing preoperative anxiety, including separation anxiety in children. [28] It also provides mild sedation, sympathicolysis, and anterograde amnesia. [6]
Adults: 30 mg/kg (typically 1–2 g), administered by intravenous therapy over 15–30 minutes, repeated 60 minutes later. It can also be given as a 500 mg/h continuous IV infusion. Children: 20–50 mg/kg followed by a maintenance infusion at 5–10 mg/kg/h. Intravenous infusions can lead to respiratory or cardiac arrest if given too quickly. [8]
Often, children who are slow to warm up respond to seemingly minor changes in their environment with big reactions. They may refuse new activities or shadow their parent at a school function.
Usual doses for midazolam are 1 mg to 2 mg where the older people receive smaller doses and obese people receive higher doses. Midazolam is metabolized in the liver and is excreted through the kidneys. [9] When midazolam is used alone, it has few side effects, but can cause respiratory depression if being used together with fentanyl. [8]