Document Detail

Failure of critically ill patients to metabolise midazolam.
MedLine Citation:
PMID:  3618995     Owner:  NLM     Status:  MEDLINE    
The pharmacokinetics of midazolam and its metabolite, 1-OH midazolam, were studied in six critically ill patients during and after a continuous intravenous infusion of midazolam. Four patients had an increased elimination half-life of midazolam; two were associated with a reduction in plasma clearance with low plasma concentrations of the metabolite, and two with normal metabolite levels and increased volume of distribution. The two patients with reduced clearance suffered from septic shock and were studied over a longer period. Their altered clearance was due to a reduced capability to form the 1-OH metabolite. As their condition improved, plasma concentrations of 1-OH midazolam increased and midazolam clearance returned towards normal. The impaired ability of critically ill patients with septic shock to metabolise midazolam, may be due to reduced organ perfusion and may lead to cumulation of midazolam in these patients.
M P Shelly; L Mendel; G R Park
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Anaesthesia     Volume:  42     ISSN:  0003-2409     ISO Abbreviation:  Anaesthesia     Publication Date:  1987 Jun 
Date Detail:
Created Date:  1987-09-23     Completed Date:  1987-09-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370524     Medline TA:  Anaesthesia     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  619-26     Citation Subset:  AIM; IM    
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MeSH Terms
Critical Care*
Hypnotics and Sedatives
Midazolam / analogs & derivatives,  metabolism*
Middle Aged
Prospective Studies
Shock, Septic / metabolism
Time Factors
Reg. No./Substance:
0/Hypnotics and Sedatives; 59467-70-8/Midazolam; 59468-90-5/1-hydroxymethylmidazolam

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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