CHAPTER V

DRUG STUDY
DRUG NO. 2
DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING
REACTIONS CONSIDERATIONS
Generic Name: May exert sedating To induce preoperative Acute angle-closure CNS: Agitation, Before:
midazolam effect by increasing sedation or amnesia, to glaucoma; alcohol delirium, or dreaming
hydrochloride activity of gamma- control preoperative intoxication; coma; during emergence from 1. Observe 12 rights in
Brand Name: aminobutyric acid, a anxiety hypersensitivity to anesthesia; anxiety; administering
Versed major inhibitory midazolam, other ataxia; chills; medication.
  neurotransmitter in the benzodiazepines, or combativeness;
Classification: brain. As a result, their components; confusion; dizziness; WARNING
Sedative-hypnotic midazolam produces a shock drowsiness; euphoria; I.V. Midazolam is given
  calming effect, relaxes excessive sedation; only in hospital or
Dosage: skeletal muscles, and— headache; insomnia; ambulatory care
Children ages 6 lethargy; nervousness; settings that allow
months to 5 years. at high doses—induces
nightmares; continuous monitoring
Initial: 0.05 to 0.1 mg/kg, sleep. paresthesia; prolonged of respiratory and
up to 0.6 mg/kg, if emergence from cardiac function. Keep
needed. anesthesia; resuscitative drugs and
Maximum: 6 mg. restlessness; retrograde equipment at hand.
  amnesia; sleep
Route: I.V.
disturbance; slurred
speech; weakness;
yawning
 DRUG STUDY
DRUG NO. 2
DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING
REACTIONS CONSIDERATIONS
CV: Cardiac arrest, 2. Inform patient that
hypotension, nodal she may not remember
rhythm, PVCs, procedure because
tachycardia, vasovagal midazolam produces
episodes amnesia.
EENT: Blurred vision,
diplopia, or other vision 3. Advise the parents to
changes; increased avoid hazardous
salivation; activities until drug’s
laryngospasm; miosis; adverse CNS effects,
nystagmus; toothache such as dizziness and
GI: Hiccups, nausea, drowsiness, have worn
retching, vomiting off.
RESP: Airway
obstruction, bradypnea,
bronchospasm,
coughing, decreased
tidal volume, dyspnea,
hyperventilation,
respiratory arrest,
shallow breathing,
 DRUG STUDY
DRUG NO. 2
DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING
REACTIONS CONSIDERATIONS
tachypnea, wheezing During:
SKIN: Pruritus, rash, 1. As needed, combine
urticaria midazolam injection with
Other: Injection site D5W, normal saline
burning, edema, solution, or lactated
induration, pain, Ringer’s solution. With
redness, and D5W and normal saline,
tenderness solution is stable 24
hours. With lactated
Ringer’s, solution is
stable 4 hours.
2. As needed, mix
injection in same
syringe with atropine
sulfate, meperidine
hydrochloride, morphine
sulfate, or scopolamine
hydrobromide. The
resulting solution is
stable for 30 minutes.
 DRUG STUDY
DRUG NO. 2
DRUG ACTION INDICATION CONTRAINDICATION ADVERSE NURSING
REACTIONS CONSIDERATIONS
After:
1. Assess level of
consciousness
frequently because the
range between sedation
and unconsciousness or
disorientation is narrow
with midazolam.

2. Be aware that
recovery time is usually
2 hours but may be up
to 6 hours.