注射液(Midazolam Injection)
Midazolam Injection (Midazolam Injection)
The main ingredients of this product are midazolam hydrochloride (maleate). Its chemical name is: 8-, chlorine -6- (2- fluorine phenyl), -1- methyl -4H-, imidazole [1,5-a][1,4], benzene two nitrogen zhuo.
[traits]
熙熙攘攘的人海之中Colorless to light yellow transparent liquid.
[pharmacology and toxicology]
This product is benzene two nitrogen Zhuo class A, and the benzene two nitrogen Zhuo receptor (BZ receptor) with BZ receptors play a role in neuron synaptic membranes, adjacent to the GABA receptor, coupled to a chloride channel in common, the level of the BZ receptor exists GABA regulatory protein, it can bind to GABA and stop the combination of this product with receptor, BZ receptor to prevent regulatory protein function, thereby enhancing the binding of GABA to its receptors, thus a series of action, and how many basis and BZ receptor binding, in order to produce anti anxiety, sedation and hypnosis, and even loss of consciousness.
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[pharmacokinetics]
This product is a lipophilic substance, in the acidic solution of PH<4 to form a stable water-soluble salt, the clinical preparation is hydrochloride or maleate, pH=3.3. Under
physiological pH conditions, its lipophilic base release rapidly through the blood-brain barrier, and the action is rapid. Because of the high fat soluble, rapidly absorbed after oral administration, 1/2 ~ 1 hours blood concentration reached the peak, through the liver first pass effect, bioavailability was 50% (T1/2a), the distribution half-life is 5 to 10 minutes, the elimination half-life (T1/2b) short, about 2 to 3 hours, the protein binding rate is high 96%, the clearance rate of 6 ~ 11ml/ (kg - min). The pharmacokinetics of midazolam in intravenous infusion were similar to that of single intravenous injection. After intramuscular injection, the absorption was rapid and basically complete. The concentration of serum reached the peak value after 30 minutes, the bioavailability was 91%, and the elimination was similar to that after intravenous injection. Midazolam is mainly oxidized in liver by hepatic microsomal enzymes.
[indications]
1.. Administration before anesthesia.
2. general anesthesia induction and maintenance.
3. medication during spinal anesthesia and local anesthesia.
4. patient sedation during diagnostic or therapeutic procedures such as angiocardiography, cardioversion, bronchoscopy, and gastrointestinal endoscopy.
5.ICU the patient is calm.
[usage and dosage]
This product is a strong sedative, the injection speed should be slow, the dosage should be based on clinical needs, the patient's physiological condition, age and the use of drugs.
1. intramuscular injection: diluted with 0.9% Sodium Chloride Injection. Intravenous administration: diluted with 0.9% Sodium Chloride Injection, 5% or 10% Glucose Injection, 5% Fructose Injection, Ringer's solution.
2. preanesthetic medication: before induction of anesthesia in 20 ~ 60 minutes, at a dose of 0.05 ~ 0.075mg/kg intramuscular injection in elderly patients with general anesthesia induction dose reduce; commonly used 5 ~ 10mg (0.1 ~ 0.15mg/kg).
3. local anesthesia or spinal anesthesia adjuvant medication, intravenous injection of 0.03 to 0.04mg/kg.
古丽扎娜The patient with 4.ICU was sedated, followed by intravenous infusion of 2 to 3mg, followed by intravenous infusion of 0.05mg/ (kg, H).
[adverse effects]
(1) the greatest adverse reaction during anesthesia or surgery was to decrease the respiratory capacity and respiratory rate, the incidence was about 10.8% to 23.3%. After intravenous injection, 15% of the patients had respiratory depression. Severe respiratory depression is common in the elderly and long-term use of the elderly, can be manifested as apnea,
asphyxia, cardiac arrest, and as far as possible death.
(2) midazolam intravenous injection, especially when combined with opioid analgesics, can cause respiratory depression and stop, and some patients can die because of hypoxic encephalopathy.
(3) after prolonged sedation, mental disorders may occur in the patient. Can also appear muscle shaking, physical control of movement or beating, rare excitement, can not be quiet, etc.. When thes
e symptoms occur, they should be dealt with. The common adverse reactions were as follows: hypotension, the incidence of intravenous injection was about 1%. Acute delirium, dim vision, disorientation, anxiety, nervousness, or restlessness.
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In addition, there are rapid heartbeat, cardiac failure, phlebitis, skin redness and swelling, rash, hyperventilation, shortness of breath and so on. The local intramuscular injection of lumps, pain; after intravenous injection, venous tenderness.
彩虹 歌词The less common symptoms are blurred vision, mild headache, dizziness, coughing and fluttering, stiff muscles and veins, weakness of the hands and feet, numbness, pain, or tingling.
[taboo]
Patients who were allergic to benzene, two or more, were suffering from myasthenia gravis, schizophrenia, and severe depressive disorder.
[matters needing attention]
1. used as a general anesthesia induction, often after a long period of sleep, should pay attention to keep the patient airway unobstructed.
2., this product can not be diluted or mixed with 6% dextran injection or alkaline injection.
左麟右李演唱会3. long term intravenous midazolam can cause withdrawal syndrome by withdrawal. It is recommended to decrease the dosage gradually.
4. intramuscular or intravenous midazolam should not leave the hospital or consulting room for at least 3 hours and should be accompanied only before leaving. You should not drive or operate machines for at least 12 hours.
5. be careful for patients with weak constitution or chronic diseases, pulmonary obstructive diseases, chronic renal failure, liver function damage or congestive heart failure patients. If midazolam is used, the dosage should be reduced and vital signs should be monitored.
6., when acute alcoholism, with it will inhibit vital signs. The patient may suffer from coma or shock, and the effect of hypotension will be prolonged; congestive heart failure can prolong T1/2 time and increase volume distribution by 2~3 times.