Midazolam
Information from Plumb's Veterinary Drug Handbook, 7th Edition, by Donald C. Plumb:
Midazolam is used principally as a premedicant for general anesthesia, generally in combination with other medications. It is also used to treat status epilepticus when given either IV or IM (not rectally).
Contraindications: Do not use in patients with hypersensitivity to benzodiazepines, acute narrow angle glaucoma, hepatic or renal disease, or debilitated and geriatric patients. Patients with congestive heart failure may eliminate the drug more slowly, and it should be used with caution. Administer with caution to patients in coma, shock, or significant respiratory depression. When used in combination with other anesthetic agents, cardiorespiratory effects may be noted.
Adverse effects: The primary concern in veterinary patients is the possibility of respiratory depression. Other adverse effects include effects on cardiac rate and blood pressure, pain on injection, local irritation, headache, nausea, vomiting, and hiccups. Midazolam has not been demonstrated to cause fetal abnormalities, but other benzodiazepines have been implicated in causing congenital abnormalities if administered in early pregnancy. Use in pregnant patients should only occur when the benefits clearly outweigh the risks. Midazolam is secreted in milk and may cause CNS effects in nursing neonates- exercise caution when administering to a nursing mother. In cases of overdose, flumazenil and supportive therapy can be administered.
Midazolam may interact with the following drugs: inhalant anesthetics, azole antifungals, calcium channel blockers, cimetidine, CNS depressants, macrolides, opiates, phenobarbital, rifampin, thiopental.
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