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Clinical Pharmacology of Midazolam in Neonates and Children : Effect of Disease—A Review
Author
Source
International Journal of Pediatrics
Issue
Vol. 2014, Issue 2014 (31 Dec. 2014), pp.1-20, 20 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2014-02-18
Country of Publication
Egypt
No. of Pages
20
Main Subjects
Abstract EN
Midazolam is a benzodiazepine with rapid onset of action and short duration of effect.
In healthy neonates the half-life (t1/2) and the clearance (Cl) are 3.3-fold longer and 3.7-fold smaller, respectively, than in adults.
The volume of distribution (Vd) is 1.1 L/kg both in neonates and adults.
Midazolam is hydroxylated by CYP3A4 and CYP3A5; the activities of these enzymes surge in the liver in the first weeks of life and thus the metabolic rate of midazolam is lower in neonates than in adults.
Midazolam acts as a sedative, as an antiepileptic, for those infants who are refractory to standard antiepileptic therapy, and as an anaesthetic.
Information of midazolam as an anaesthetic in infants are very little.
Midazolam is usually administered intravenously; when minimal sedation is required, intranasal administration of midazolam is employed.
Disease affects the pharmacokinetics of midazolam in neonates; multiple organ failure reduces the Cl of midazolam and mechanical ventilation prolongs the t1/2 of this drug.
ECMO therapy increases t1/2, Cl, and Vd of midazolam several times.
The adverse effects of midazolam in neonates are scarce: pain, tenderness, and thrombophlebitis may occur.
Respiratory depression and hypotension appear in a limited percentage of infants following intravenous infusion of midazolam.
In conclusion, midazolam is a safe and effective drug which is employed as a sedative, as antiepileptic agent, for infants who are refractory to standard antiepileptic therapy, and as an anaesthetic.
American Psychological Association (APA)
Pacifici, Gian Maria. 2014. Clinical Pharmacology of Midazolam in Neonates and Children : Effect of Disease—A Review. International Journal of Pediatrics،Vol. 2014, no. 2014, pp.1-20.
https://search.emarefa.net/detail/BIM-462363
Modern Language Association (MLA)
Pacifici, Gian Maria. Clinical Pharmacology of Midazolam in Neonates and Children : Effect of Disease—A Review. International Journal of Pediatrics No. 2014 (2014), pp.1-20.
https://search.emarefa.net/detail/BIM-462363
American Medical Association (AMA)
Pacifici, Gian Maria. Clinical Pharmacology of Midazolam in Neonates and Children : Effect of Disease—A Review. International Journal of Pediatrics. 2014. Vol. 2014, no. 2014, pp.1-20.
https://search.emarefa.net/detail/BIM-462363
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-462363