An Overview Of Antidote For Midazolam Overdose, Role Of Clinical Laboratory, Anesthesia And Nursing In The Management

Abstract

Midazolam is commonly administered as a premedication due to its beneficial properties of inducing amnesia, reducing anxiety, and promoting sedation. Incorrect administration of midazolam at an inappropriate dosage elevates the likelihood of respiratory and circulatory depression. An individual died as a consequence of receiving a 10 mg dosage of intravenous (IV) midazolam during an endoscopic procedure.1 While there is no documented evidence of fatalities resulting from the intramuscular (IM) administration of midazolam, we have encountered two instances of excessive doses of IM midazolam being delivered. Thankfully, there were no issues. However, the occurrences highlighted the reality that certain doctors and nurses may lack the necessary expertise in administering a drug, even if it has been widely used for an extended period of time. Only a few examples have been recorded in the literature where the premedication of IM midazolam was administered at a dosage four times higher than recommended. The sedative effects were extended, however, there was no occurrence of circulatory or respiratory depression, which is fortunate. Both accidents occurred due to the nurse and resident's inadequate familiarity with midazolam. Hence, it is imperative not to assume that all medical personnel possess equivalent experience and expertise regarding frequently utilized medications. It is crucial to thoroughly examine prescriptions and processes, especially for common medications, in order to prevent unintentional overdoses. The clinical laboratory, anesthesia, and nursing play crucial roles in managing patients, including tasks such as identifying drug levels in urine, administering antidotes, performing intubation, and providing more effective therapy with the help of the anesthesia team.