Seizalam (midazolam intramuscular) / Pfizer - LARVOL DELTA

Use of Intramuscular Midazolam, Diphenhydramine, and Haloperidol in Acute Agitation Management in a Psychiatric Emergency Department. (PubMed, J Clin Psychopharmacol) - "This is the first study to examine coadministration of intramuscular midazolam with haloperidol and diphenhydramine. Midazolam+ was effective at managing agitation and may be an alternative to lorazepam+."

Journal • Anesthesia • Psychiatry

Effect of Dexmedetomidine Hydrochloride Nasal Spray on Preoperative Sedation and Perioperative Neurocognitive Disorders in Patients Undergoing Coronary Artery Bypass Grafting: A Randomized Controlled Study (ChiCTR) - P=N/A | N=118 | Not yet recruiting | Sponsor: The Second Hospital of Hebei Medical University; The Second Hospital of Hebei Medical University

New trial • Anesthesia • CNS Disorders • Cognitive Disorders • Developmental Disorders

Unforeseen anaphylactic reaction in a young healthy patient undergoing arthroscopic meniscectomy: a case report (Euroanaesthesia 2025) - "The preoperative sciatic and saphenous nerve blocks with 80 mg of 0.2% Ropivacaine, accompanied by light sedation using midazolam (2 mg) and fentanyl (50 mcg), initiated a cascade of unexpected events during the subsequent general anesthesia induction.Case report: Post-peripheral nerve blocks, general anesthesia induction with 50 mcg of fentanyl and 150 mg of propofol resulted in rapid and profound desaturation, indicating severe bronchospasm. She was intubated and was administered 100 mg of ketamine, 2g of magnesium sulfate, 200 mg of hydrocortisone and 30 mg of rocuronium intravenously, 300 mcg of adrenaline intramuscular, 400 mcg of salbutamol and sevoflurane inhaled, with recovery of the vital signs...Several cases of anaphylaxis to propofol or fentanyl have been described.1,2.Anesthesiologists must acknowledge the unpredictable nature of such events and respond promptly with tailored interventions. This case serves as a compelling reminder of the imperative for..."

Case report • Clinical • Anesthesia • Cardiovascular • CNS Disorders • Depression • Immunology • Myocardial Ischemia • Orthopedics • Psychiatry

Navigating Medication Shortages: Comparative Efficacy of Lorazepam and Midazolam in Managing Agitation Among Psychiatric Inpatients (APA 2025) - "Lorazepam is frequently used, often in conjunction with haloperidol, but has faced shortages in 2022 and remains scarce as of August 2024. 120 patients were analyzed: 97 received lorazepam and 13 received midazolam. The population was on average 40 years old, and 53% male. Over 80% had a primary psychotic disorder."

Clinical • CNS Disorders • Psychiatry

Injection of Diquat - A Fatal Case of Suicide (ATS 2025) - "Upon arrival to the intensive care unit, he experienced a generalized seizure and was treated with midazolam and phenobarbital...In addition, N-acetylcysteine, deferoxamine, vitamins C and E, aspirin, dexamethasone, and lower oxygen saturation goals were initiated to mitigate ROS...There is limited knowledge of treatments beyond supportive care, and the effects of injecting diquat are lesser known than those of ingestion. This case highlights the rapid, devastating outcomes of diquat poisoning."

Clinical • Acute Kidney Injury • Cardiovascular • CNS Disorders • Depression • Epilepsy • Metabolic Disorders • Nephrology • Psychiatry • Renal Disease • Respiratory Diseases

IM Ketamine vs Midazolam for Suicidal ER Patients (clinicaltrials.gov) - P4 | N=90 | Suspended | Sponsor: New York State Psychiatric Institute | Trial completion date: Mar 2026 ➔ Mar 2028 | Active, not recruiting ➔ Suspended | Trial primary completion date: Dec 2025 ➔ Sep 2027

Trial completion date • Trial primary completion date • Trial suspension • Bipolar Disorder • CNS Disorders • Depression • Major Depressive Disorder • Mood Disorders • Psychiatry • Suicidal Ideation

Accidental coadministration of medetomidine, vatinoxan and ketamine in a cat. (PubMed, Vet Anaesth Analg) - "The anaesthetic plan included intramuscular medetomidine (30 μg kg-1) and tramadol (2 mg kg-1) for premedication followed by intramuscular ketamine (8 mg kg-1) for induction of general anaesthesia...Midazolam (0.2 mg kg-1) was given intravenously to counteract agitation...Tachycardia may have been secondary to the effects of vatinoxan (offsetting bradycardia caused by the alpha-2 adrenergic receptor agonist) and ketamine (increasing heart rate), and the excitement resulting from the decreased plasma concentration of medetomidine (inadequate to counteract ketamine effects) when it is combined with vatinoxan. Given the inherent limitations of a single case observation, the ability to conclusively determine causes of the observed adverse events are limited."

Journal • Anesthesia • Ataxia • Cardiovascular • Movement Disorders • Ophthalmology

Management of refractory hypotension during adrenalectomy in a dog treated with phenoxybenzamine. (PubMed, Vet Anaesth Analg) - "Anesthetic premedication consisted of methadone (0.3 mg kg-1) intravenously (IV) and atropine (0.02 mg kg-1) intramuscularly. General anesthesia was induced with alfaxalone (1.5 mg kg-1 IV) and midazolam (0.3 mg kg-1 IV) and maintained with isoflurane in oxygen delivered via a circle breathing system...The owners decided to euthanize the dog. This report describes the use of an irreversible alpha-1 adrenergic receptor antagonist to treat severe preoperative hypertension (MAP 45 mmHg) associated with a malignant adrenal gland tumor and the subsequent challenges in managing arterial blood pressure intraoperatively."

Journal • Anesthesia • Cardiovascular • Endocrine Cancer • Hypertension • Hypotension • Oncology • Solid Tumor • ADRA1B

Intranasal alfaxalone in cockatiels (Nymphicus hollandicus) does not produce sedation compared to intramuscular alfaxalone with or without midazolam. (PubMed, Am J Vet Res) - "Intranasal alfaxalone at 15 mg/kg did not produce sedation. Intramuscular alfaxalone at 15 mg/kg with midazolam at 3 mg/kg produced sedation in cockatiels."

Journal • Anesthesia

Maternal MitoQ Treatment Is Protective Against Programmed Alterations in CYP Activity Due to Antenatal Dexamethasone. (PubMed, Pharmaceutics) - "In 9 mo lambs, MitoQ alone increased activity of CYP2B6 (+16%, PMitoQ = 0.0011) and CYP3A (midazolam, +25%, PMitoQ = 0.0162) and increased CAT expression (PMitoQ = 0.0171). All treatments decreased fetal hepatic DRP1, a regulator of mitochondrial fission (PDex = 0.0055, PMitoQ = 0.0006 and PIntx = 0.0034). Antenatal Dex reduced activity of only one CYP in the fetus but programmed the reduced activity of several hepatic CYPs in young adult offspring, and this effect was ameliorated by combination with MitoQ."

Journal • CYP1A2 • CYP2E1 • CYP3A4

"Pharmacological management of acute agitation in psychiatric patients: an umbrella review". (PubMed, BMC Psychiatry) - "This umbrella review offers a comprehensive overview of the pharmacological management of psychomotor agitation in patients with psychiatric disorders. Among the most frequently used medications in the reviewed studies were haloperidol, olanzapine, and lorazepam. The findings underscore the importance of tailored treatment approaches and the need for further research to refine the management of psychomotor agitation in psychiatric settings."

Journal • Review • Anesthesia • Bipolar Disorder • CNS Disorders • Mental Retardation • Mood Disorders • Psychiatry • Psychomotor Agitation

Acute Pain Management in People With Opioid Use Disorder : A Systematic Review. (PubMed, Ann Intern Med) - "Single well-conducted randomized controlled trials in emergency department (ED) or perioperative settings in adults not prescribed medications for OUD suggest oral clonidine, intramuscular haloperidol and midazolam with intravenous (IV) morphine, and intraoperative IV lidocaine may improve pain outcomes and warrant study in diverse patient populations. Few studies evaluated methadone or the effect of interventions on OUD outcomes...None. (Protocol registered a priori on Open Science Framework [https://osf.io/25hbs])."

Journal • Review • Addiction (Opioid and Alcohol) • Pain • Substance Abuse

INTRAMUSCULAR MIDAZOLAM AND BUTORPHANOL ADMINISTERED PRIOR TO INTRAVENOUS ALFAXALONE PROVIDES SAFE AND EFFECTIVE ANESTHESIA IN GENTOO PENGUINS (PYGOSCELIS PAPUA). (PubMed, J Zoo Wildl Med) - "Heart rates were maintained within the normal physiological range, and noninvasive blood pressure remained stable. Compared with previous investigations on anesthesia induction and maintenance using alfaxalone alone, the intramuscular administration of 0.25 mg/kg midazolam and 0.25 mg/kg butorphanol reduced the alfaxalone dose requirement for anesthesia induction and maintenance, thereby shortening recovery times."

Journal • Anesthesia

A modified Delphi consensus on the use of intramuscular midazolam for early status epilepticus treatment (ESET) in Malaysia. (PubMed, Seizure) - "While Malaysian healthcare professionals are aware of rescue medications for prehospital seizure emergencies, they lack an understanding of IM midazolam's benefits. Key barriers include unfamiliarity and lack of protocols despite strong consensus on its first-line use."

Journal • CNS Disorders • Epilepsy

Clevidipine for hypertension treatment during laparoscopic adrenalectomy for pheochromocytoma in a dog. (PubMed, Vet Anaesth Analg) - "Anesthetic premedication was performed with methadone (0.5 mg kg-1) intramuscularly and maropitant (1 mg kg-1) subcutaneously. General anesthesia was induced with intravenous (IV) alfaxalone (1 mg kg-1) and midazolam (0.3 mg kg-1) and maintained with isoflurane in oxygen delivered through a circle breathing system. Dexmedetomidine (0.5 μg kg-1 bolus over 5 minutes, followed by 0.5 μg kg-1 hour-1), magnesium sulfate (50 mg kg-1 hour-1 for the first hour, followed by 15 mg kg-1 hour-1) and lactated Ringer's solution (5 mL kg-1 hour-1) were given IV...The dog was discharged from the hospital 3 days after surgery and its clinical status has been stable for 2 years after the procedure. This case report describes the successful treatment of hypertension using clevidipine, a specific arterial vasodilator with fast onset and offset of action and a low incidence of adverse effects."

Journal • Anesthesia • Cardiovascular • Endocrine Cancer • Hypertension • Oncology • Solid Tumor

KETAMINE AS A RESCUE DRUG FOR BENZODIAZEPINE-RESISTANT STATUS EPILEPTICUS IN THE PREHOSPITAL SETTING (SCCM 2025) - "Among adults with on-going out-of-hospital seizures resistant to significant dosings of midazolam, ketamine was consistently effective in terminating those convulsions. Near-similar results were achieved in children/adolescents."

Clinical • CNS Disorders • Epilepsy

Orthotopic Transplantation of Native and Cryopreserved Ovarian Tissue in Day-Old Geese. (PubMed, Vet Sci) - "The surgical protocol previously used in chickens needed to be modified regarding anaesthesia; ketamine, xylazine, and midazolam were administered partly intramuscularly and partly intravenously. The highest rate of donor-originated progeny was 78.9%. Consequently, gonadal tissue transplantation appears to be a suitable method for preserving female genetic material in domestic geese; the technique is already implemented in Hungarian gene bank practice."

Journal • Anesthesia • Transplantation

Evaluation of different intramuscular injectable anesthetic combinations in rabbits: Impact on anesthetic depth, physiological parameters, and EEG recordings. (PubMed, PLoS One) - "Defined doses ketamine (K), esketamine (SK), medetomidine (M), dexmedetomidine (D), midazolam (Mi), and butorphanol (B) were investigated and compared in five different combinations: KM (25/0.25 mg/kg), SKM (17/0.25 mg/kg), SKD (17/0.15 mg/kg), MMiB (0.25/1/0.2 mg/kg), and DMiB (0.15/1/0.2 mg/kg). Monitoring circulatory parameters during and after anesthesia and adequate pain management pre-, inter-, and postoperatively are essential. Considering these criteria, the KM group presented the best results compared with the other groups."

Journal • Preclinical • Anesthesia • CNS Disorders • Pain

A preliminary exploration of liver microsomes and PBPK to uncover the impact of CYP3A4/5 and CYP2C19 on tacrolimus and voriconazole drug-drug interactions. (PubMed, Sci Rep) - "Midazolam and testosterone were used as probe substrates to evaluate individual differences in CYP3A4/5 metabolic activity. These findings can serve as a valuable point of reference for concurrently administering these two medications. These findings also indicate that the genotypes of CYP2C19 play an important role in the development of DDI during concurrent Tacrolimus and Voriconazole treatment, which may have some guidance for clinical medication."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Transplantation • CYP2C19 • CYP3A4 • CYP3A5

Could Flumazenil Be Used Pre-hospital by Intramuscular Injection for Coma due to Mixed Drug Overdose Not Responding to Naloxone?: A Systematic Review of the Evidence. (PubMed, Basic Clin Pharmacol Toxicol) - "IM flumazenil data are sparse, but it may be effective and safe. Clinical research is urgently needed to determine whether pre-hospital IM flumazenil can prevent benzodiazepine-involved overdose deaths."

Journal • Review • Anesthesia • CNS Disorders • Epilepsy

The effect of midazolam co-induction on cardiorespiratory variables, myoclonus and etomidate dose requirements in healthy cats. (PubMed, Vet Anaesth Analg) - "Etomidate, with or without midazolam co-induction, provides acceptable cardiovascular function in premedicated healthy cats. Midazolam reduces etomidate requirements for orotracheal intubation and improves induction quality in cats premedicated with intramuscular butorphanol-alfaxalone."

Journal • Anesthesia • Cardiovascular • Hematological Disorders • Movement Disorders

Strategies to innovate emergency care of status epilepticus. (PubMed, Neurotherapeutics) - "Although three different benzodiazepines, diazepam, lorazepam and midazolam terminate early SE, midazolam is preferred...Interestingly, children treated with fosphenytoin were more likely to require intubation than those treated with valproic acid or levetiracetam. Better therapies are needed for the treatment established SE, because all three drugs were effective in less than 50 ​% of the patients."

Journal • Review • Cardiovascular • CNS Disorders • Epilepsy • Hypotension

Consensus Guideline for Care of Patients in the Prehospital and Aerospace Settings with Exposures to Hydrazine and Hydrazine Derivatives. (PubMed, Prehosp Emerg Care) - "The consensus guideline for clinical care of patients with exposure to HZ/HZ-Ds is as follows: Prior to decontamination, use appropriate personal protective equipment, and when necessary, support ventilation using a bag-valve-mask and administer midazolam intramuscularly for seizures. After decontamination, provide supplemental oxygen; consider selective advanced airway management when indicated; administer inhaled beta-agonists for wheezing; and, for seizures unresponsive to multiple doses of benzodiazepines that occur during pre-planned, high-hazard activities, such as spacecraft recovery, consider intravenous or intraosseous pyridoxine."

Journal • CNS Disorders • Epilepsy

Evaluation of Anticonvulsant Efficacy of the KCC2 Activator, OV350, in a Rat Model of Nerve Agent Poisoning (AES 2024) - "OV350 was evaluated as an adjunctive therapy to standard medical countermeasures (SMCs) atropine, 2-PAM, and midazolam. Methods were based on a model of nerve agent-induced BDZ-RSE that has been previously published [1]. These data suggest that the KCC2 activator, OV350, can act to terminate seizures, improve survival, and protect from the associated brain tissue damage following soman exposure plus SMCs."

Preclinical • CNS Disorders • Epilepsy

Allopregnanolone Terminates Soman-induced Electrographic Status Epilepticus in Rats: Analysis Using a Novel Translationally Aware Approach Based on Standardized Clinical Criteria (AES 2024) - "We compared the effects of the current standard-of-care treatment for OP-induced status epilepticus, which is 2 doses of midazolam (MDZ), with 1 dose of MDZ followed by ALLO on ESE induced in rats by soman. A new analysis approach has been developed that identifies ESE according to currently accepted clinical criteria. Using this method, MDZ failed to terminate ESE whereas ALLO at a high dose was effective, supporting the potential utility of high dose ALLO in the treatment of benzodiazepine-refractory status epilepticus. The novel analysis method may have application broadly in the study of treatments for status epilepticus."

Preclinical • CNS Disorders • Epilepsy