VERSED 1. Name & class of drug – generic and trade name.

GENERIC NAME: Midazolam Hydrochloride BRAND NAME: Versed CLASSIFICATION: CNS agent, benzodiazepine, anxiolytic, sedative-hypnotic 2. Dose range and routes for adult & geriatric client. PREPARATIONS: PO – 2mg/ml syrup IV/IM – 1mg/ml, 5mg/ml DOSING: Conscious sedation – (IM) 0.07-0.08 mg/kg 30-60 min before procedure (IV) 1-1.5 mg, may repeat in 2 min prn Intubated pts – 0.05 – 0.2 mg/kg/hr by continuous infusion 3. Purpose prescribed. Underline reason your client is prescribed drug. THERAPEUTIC EFFECTS: CNS depressant with muscle relaxant, sedative-hypnotic, anticonvulsant, and amnestic properties USES: sedation before general anesthesia, induction of general anesthesia; to impair memory of perioperative events (anterograde amnesia); conscious sedation prior to short diagnostic and endoscopic procedures; hypnotic supplement to nitrous oxide and oxygen (balances anesthesia) for short surgical procedures. 4. Major side effects & drug interactions. DRUG INTERACTIONS: alcohol, CNS depressants, anticonvulsants potentiate CNS depression • Cimetidine increases midazolam plasma levels, increasing its toxicity; • May decrease antiparkinsonism effects of levodopa • May increase levels of phenytoin • Smoking decreases sedative and antianxiety effects

HERBAL INTERACTIONS: kava-kava, valerian may potentiate sedation SIDE EFFECTS: retrograde amnesia, hiccups, chills, weakness 5. Nursing Implications & teaching. IMPLICATIONS: inspect insertion site for redness, swelling and pain, signs of extravasation during IV infusion • Monitor for hypotension, especially it pt is also receiving narcotic agonist • Monitor vitals during entire recovery period. In obese pts, half life is prolonged during IV infusion, therefore duration of effect is prolonged • Overdose symptoms may include somnolence, confusion, sedation, diminished reflexes, coma, and untoward effect on vital signs TEACHING: do not drive or engage in hazardous activities until response to drug is known. • You may feel drowsy, weak or tired for 1-2 d after drug has been given • Be prepared for amnesia to prevent an upsetting post-op period • Review written instructions to assure future understanding and compliance. Pt teaching during amnestic period may not be remembered. Even if dose is small, and depth of amnesia is unclear, relearn information.