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What Is Intranasal Midazolam?

By Jillian O Keeffe
Updated May 17, 2024
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Intranasal simply means "through the nose" and it is one way of administering medication. Midazolam is a drug that is used for sedation, and has applications for a variety of medical conditions. Intranasal midazolam is, however, primarily used to treat people, especially children, who suffer from convulsions, as it is safer than attempting oral or injection drug administration for these patients. A major advantage of intranasal midazolam over other delivery formats is that it does not require specialist training to administer.

Sedation and calming of the patient through medication can help control seizures, as the medicines affect the workings of the brain and control the associated movements of the body. Although midazolam is primarily used for sedating kids who are about to undergo surgery, it is also useful in treating seizures in an emergency situation. Normally, the intranasal form of the drug is actually the vial product for injection, but instead of injecting the drug, the person administering it simply drips the liquid drug into the inside of the nose.

Once inside the nose, the drug moves through the membranes into the blood system. An alternate way of delivering the drug is through dripping it into the mouth so it can diffuse through the inside of the cheek. These forms of drug delivery are not commonly used in medicine, but are useful in situations such as seizures because the patient cannot swallow properly, or may move around too much for an injection to be given safely. In addition, the carer of the person who suffers regular convulsions can easily learn to give the medicine without much specialist training or having to carry around needles. A doctor can instruct the carer as to how much of the midazolam is appropriate for a particular patient, as dosages can vary by body weight or by severity of convulsions.

Possible side effects of intranasal midazolam include skin rashes and nausea. The patient may suffer headaches, and begin to hiccup or even vomit. Generally the drug produces a drowsiness which persists for a time after use, and a person who takes intranasal midazolam should avoid doing anything which may be dangerous when drowsy, such as driving or cycling.

Serious side effects are possible with the use of midazolam, and these may require emergency medical attention. Interference with normal breathing is possible, where the patient breathes much more slowly, or in short breaths, or even stops breathing altogether. Aggressive or agitated behaviors are also associated with midazolam usage, but these are only temporary issues.

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