VERSED (MIDAZOLAM)

Class

Benzodiazepine, Sedative and Hypnotic

Pharmacology and Actions

1. CNS depressant leading to sedation and amnesia
2. Versed is 3 to 4 times more potent than Diazepam
3. Like other benzodiazepines, it has no effect on pain

Indications

1. Sedation for cardioversion or transcutaneous pacing (TCP)
2. Used with succinylcholine for rapid sequence intubation (RSI)
3. Continued sedation of the intubated patient

Contraindications

1. Patients with a history of hypersensitivity to benzodiazepines
2. Narrow angle glaucoma

Precautions

1. Can cause significant respiratory depression, apnea, and hypotension. Especially when used in combination with other sedatives such as alcohol or narcotics. Continuous pulse oximetry and cardiac monitoring are mandatory. Resuscitative equipment must be immediately available.
2. Consider lower doses for elderly patients; significant respiratory depression, apnea, and hypotension are more frequently encountered.

Administration

1. RSI:   2 mg IV/IO, may repeat one time if inadequate sedation obtained.
2. Cardioversion:  2 mg slowly IV/IO if indicated; May repeat to max dose of 4 mg
3. Pediatric maximum dosage is 10 mg.
4. Behavioral Emergencies:  2 mg slowly IV/IO/IN if indicated; May repeat to max dose of 4 mg

Side Effects and Special Notes

1. Hypotension
2. Respiratory depression
3. Amnesia