Saturday, July 23, 2011

Another Article About The DANGER Of Midazolam

Here's the site;Patient Safety Tip of the Week Archive

Here are a few notable quotes about the use, misuse and overuse of Midazolam aka Versed.

"Failure to titrate the dose to the needs of the patient was noted to be a common problem. They did note that a high reliance on using flumazenil to reverse the effects of midazolam may have contributed to use of excessive doses of midazolam as well and conclude that the routine use of flumazenil reversal is not a good practice." (In my opinion any amount of Midazolam is an excessive dose. This is shocking! Failure to titrate when this particular poison is fatal in tiny amounts and if given quickly! As for the "needs of the patient" what a crock. Versed isn't given for the "needs of the patient" most of them time, if at all. Then they want to rely on an antidote so that they can over sedate people? This is crazy.)

"While all these issues appear in the detailed prescribing information on midazolam available through the FDA and other reputable drug information resources, practitioners seldom read through those details at the time a procedure is being performed. The NPSA rapid response report would suggest that a false comfort level with the “safety” of IV midazolam has developed and that understanding of the substantial risks involved has not been routinely appreciated. (Did you get that? A FALSE comfort level with the "safety' of IV Midazolam has developed!!! Understanding the SUBSTANTIAL RISKS involved has not been routinely appreciated!!! Ya think?)

"As a class, benzodiazepines are the drugs most commonly precipitating delirium (see our prior columns pertaining to preventing delirium and managing delirium) and they are on Beer’s List of drugs that should be avoided in the elderly (see our January 15, 2008 Patient Safety Tip of the Week Managing Dangerous Medications in the Elderly ” and June 2008 What’s New in the Patient Safety World “Potentially Inappropriate Medication Use in Elderly Hospitalized Patients”). Yet their use continues to be widespread, both in inpatients and outpatients. When we are asked about topics a hospital should choose for conducting a FMEA (Failure Mode and Effects Analysis), we often suggest looking at benzodiazepine use (either in toto or just the parenteral use). When you do such a FMEA, you’ll be amazed at what you find in your organization. We truly, in most organizations, have developed a comfort level with the use of these drugs that is clearly not warranted." (I LOVE, LOVE, LOVE the last line of this one... Can you hear me now medical people?)

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