미다졸람

용도

• As a preoperative agent
• As a preoperative agent
• As a preoperative agent
• For status epilepticus
• Emergency management of seizures including status epilepticus
• As a preoperative agent
• For seizure control in foals
• For seizure control in foals
• For adjunctive use (with an analgesic) for pain control
• As a pre-med for anxious or easily stressed birds
• As part of an injectable anesthetic regimen
• As a tranquilizer (to increase relaxation of lightly anesthetized animals and permit ET intubation) in Rabbits
• Tranquilizer/Sedative in Rabbits

투여 방법

가능한 부작용

• Respiratory depression (especially when combined with opioids or other CNS depressants)
• Paradoxical excitement, dysphoria, or agitation (especially in cats and dogs when used alone)
• Hypotension and bradycardia (when combined with other anesthetics like isoflurane or ketamine)
• Pain on injection or local irritation (rare compared to diazepam)
• Respiratory depression
• Severe hypotension
• Paradoxical excitement (occasionally)

주의사항 및 금기

• Hypersensitivity to benzodiazepines
• Acute narrow-angle glaucoma
• Intra-carotid artery injection (must be avoided)
• Neonates (avoid use)
• > **High-Risk Patients:** Use cautiously in patients with hepatic or renal disease, and in debilitated or geriatric patients. * **Cardiovascular/Respiratory:** Administer with extreme caution to patients in coma, shock, or with significant respiratory depression. Patients with congestive heart failure may eliminate the drug more slowly. * **Anesthetic Combinations:** While midazolam alone has minimal cardiorespiratory effects, combining it with opioids, ketamine, or inhalants can lead to significant respiratory depression, bradycardia, or hypotension. * **Pregnancy:** FDA Category D in humans. May cause congenital abnormalities if used in the first trimester. Excreted in milk and may cause CNS effects in nursing neonates.

약물 상호작용

• Inhalational Anesthetics (e.g., Isoflurane): Midazolam may decrease the dosages required for inhalant anesthetics.
• Azole Antifungals (ketoconazole, itraconazole, fluconazole): May inhibit midazolam metabolism, increasing midazolam blood levels.
• Calcium Channel Blockers (diltiazem, verapamil): May increase midazolam levels.
• Cimetidine: May increase midazolam levels by inhibiting hepatic metabolism.
• Other CNS Depressants: May increase the risk of profound sedation and respiratory depression.
• Macrolide Antibiotics (erythromycin, clarithromycin): May increase midazolam levels.
• Opiates: May increase the hypnotic effects of midazolam; hypotension has been reported when used with meperidine. Combination causes greater respiratory depression.
• Phenobarbital: May decrease peak levels and AUC of midazolam via enzyme induction.
• Rifampin: May decrease peak levels and AUC of midazolam.
• Thiopental: Midazolam may decrease the dosages required for induction.

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