- For premedication prior to anaesthesia, particularly in debilated elderly animals, high risk cardia patients, epileptics, and before procedures
- For sedation during intensive care treatment
- Foals under ONE month as premedication prior to anaesthesia
- When used in combination with other sedaties midazolam provides predictable sedation
- In humans, midazolam has been sued as a premedication prior to surgery.
- It also has shown some benefit in status epilepticus when given IV or IM (not rectally)
Midazolam is a short acting benzodiazepine derviative. The exact mechanism of effect is not clearly documented but it is predicted mechanisms include: antagonism of serotonin, increased release of and/or facilitation of gamma-aminobutyric acid (GABA) and diminished release or turnover of acetylcholine in the CNS.
Midazolam has a unique characteristics which make it nearly 3 times as potent and with a faster onset of action and shorter total duration of effect
Following IM injection midazolam is rapidly and nearly completely (91%) absorbed. Midazolam is well absorbed after oral administration but because a rapid first pass effect, bioavailability is limited. Also, in dogs rectal bioavailability has been demonstrated to be very low when compared to diazepam.
The drug is highly proteion bound and rapdily crosses the blood brain barrier.
Midazolam undergoes hepatic elimination. It has an active drug metabolite which typically has even short duration of effect and lower pharmacologic activity. Therefore, it is generally understood to only have negligible effects.
The half life of midazolam in dogs averages 77 minutes (vs 30 hours for diazepam).
The following contra-indications across different specifies include:
- hypersensitivity to benzodiazepines
- acute narrow angle glaucoma
- Intra-carotid artery injections of midazolam
The following precautions have been recorded with the use of Midazolam.
- hepatic and renal disease
- debiltated and geriatric dises
- congestive heart failure
- disease contributing to respiratory depression such as shock
Adverse Effects The following adverse effects have been reported:
br>Respiratory depression when combined with sedatives and COPD, cardiac effects and blood pressure effects
Pain on injection, local irritation, headache, nausea and vomiting and hiccups