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Midazolam is a Schedule IV drug under the Convention on Psychotropic Substances. [81] In the United Kingdom, midazolam is a Schedule 3/Class C controlled drug. [ 82 ] In the United States, midazolam (DEA number 2884) is on the Schedule IV list of the Controlled Substances Act as a non-narcotic agent with low potential for abuse.
Onset of action is the duration of time it takes for a drug's effects to come to prominence upon administration. With oral administration , it typically ranges anywhere from 20 minutes to over an hour, depending on the drug in question.
The term injection encompasses intravenous (IV), intramuscular (IM), subcutaneous (SC) and intradermal (ID) administration. [35] Parenteral administration generally acts more rapidly than topical or enteral administration, with onset of action often occurring in 15–30 seconds for IV, 10–20 minutes for IM and 15–30 minutes for SC. [36]
Finally, note that the benzodiazepine core is a privileged scaffold, which has been used to derive drugs with diverse activity that is not limited to the GABA A modulatory action of the classical benzodiazepines, [60] such as devazepide and tifluadom, however these have not been included in the list below. 2,3-benzodiazepines such as tofisopam ...
It has slow onset of action when used alone, but the onset can be improved when using together with an opioid. [9] However, for those with hypotension, midazolam can further reduce the blood pressure and has cardiac depressive effects. [14] Therefore, dose reduction is required for the elderly, and for those with heart and liver failure. [8]
In a hospital environment, intravenous clonazepam, lorazepam, and diazepam are first-line choices. In the community, intravenous administration is not practical and so rectal diazepam or buccal midazolam are used, with a preference for midazolam as its administration is easier and more socially acceptable. [51] [52]
It is available as a clear, colourless solution for intravenous injection, containing 500 μg in 5 mL. [citation needed] Additional doses may be needed within 20 to 30 minutes if evidence of oversedation reappears. [11] Many benzodiazepines (including midazolam) have longer half-lives than flumazenil.
Etomidate [3] (USAN, INN, BAN; marketed as Amidate) is a short-acting intravenous anaesthetic agent used for the induction of general anaesthesia and sedation [4] for short procedures such as reduction of dislocated joints, tracheal intubation, cardioversion and electroconvulsive therapy.