title: Pharmacokinetics - Neonatal Intensive Care Drug Manual
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  Neonatal Intensive Care Drug Manual
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  bet | 362/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Pharmacokinetics
  Midazolam is highly protein bound with an elimination half-life of 4−6 hours in term neonates and a variable half-life (up to 22 hours) in premature neonates and those with impaired hepatic function.
  Bioavailability is approximately 36% with oral administration and 50% with sublingual and intranasal administration [6] (Level III, Grade C).
  Practice points
  References
  Ng E, Taddio A, Ohlsson A. Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit. The Cochrane database of systematic reviews. 2012;6:CD002052.
  Castro Conde JR, Hernandez Borges AA, Domenech Martinez E, Gonzalez Campo C, Perera Soler R. Midazolam in neonatal seizures with no response to phenobarbital. Neurology. Mar 8 2005;64(5):876–879.
  Van Alfen-van der Velden AA, Hopman JC, Klaessens JH, Feuth T, Sengers RC, Liem KD. Effects of midazolam and morphine on cerebral oxygenation and hemodynamics in ventilated premature infants. Biology of the Neonate. 2006;90(3):197–202.
  Burtin P, Daoud P, Jacqz-Aigrain E, Mussat P, Moriette G. Hypotension with midazolam and fentanyl in the newborn. Lancet. Jun 22 1991;337(8756):1545–1546
  Bernet V, Latal B, Natalucci G, Doell C, Ziegler A, Wohlrab G. Effect of sedation and analgesia on postoperative amplitude-integrated EEG in newborn cardiac patients. Pediatr Res. Jun 2010;67(6):650–655.
  De Wildt SN, Kearns GL, Hop WC, Murry DJ, Abdel-Rahman SM, van den Anker JN. Pharmacokinetics and metabolism of intravenous midazolam in preterm infants. Clin Pharmacol Ther. 2001 Dec;70(6):525–31.
  Taketomo CK, Hodding JH, Kraus DM, American Pharmacists Association. Pediatric and neonatal dosage handbook. Hudson, Ohio: Lexi-Comp: American Pharmacists Association; 2015.
  Australian Injectable Drugs Handbook, 6th Edition, Society of Hospital Pharmacists of Australia 2014.
  Van Den Broek MP, Van Straaten HL, Huitema AD, Egberts T, Toet MC, De Vries LS, Rademaker K, Groenendaal F. Anticonvulsant effectiveness and hemodynamic safety of midazolam in full-term infants treated with hypothermia. Neonatology. 2015 Jan 8;107(2):150-6.
  Original version Date: 23/03/2016
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  Author: NMF Consensus Group
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  Current Version number: 2
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  Version Date: 16/11/2020
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  Risk Rating: Low
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  Due for Review: 16/11/2025
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  Approved by: DTC
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  Approval Date: TBA
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