PDF(Pubmed)
Abstract：
Midazolam, a short-acting benzodiazepine, is widely used to alleviate patient anxiety, enhance compliance, and aid in anesthesia. While its side effects are typically dose-dependent and manageable with vigilant perioperative monitoring, serious cardiorespiratory complications, including fatalities and permanent neurological impairment, have been documented. Prolonged exposure to benzodiazepines, such as midazolam, has been associated with neurological changes in infants. Despite attempts to employ therapeutic drug monitoring for optimal sedation dosing, its efficacy has been limited. Consequently, efforts are underway to identify alternative predictive markers to guide individualized dosing and mitigate adverse effects. Understanding these factors is crucial for determining midazolam\'s suitability for future administration, particularly after a severe adverse reaction. This article aims to elucidate the factors influencing midazolam\'s pharmacokinetics and pharmacodynamics, potentially leading to adverse events. Finally, a case study is presented to exemplify the complex investigation into the causative factors of midazolam-related adverse events.
摘要：
咪达唑仑,短效苯二氮卓类药物,广泛用于缓解患者的焦虑，加强合规性，并帮助麻醉。虽然其副作用通常是剂量依赖性的，并且可以通过警惕的围手术期监测来控制，严重的心肺并发症，包括死亡和永久性神经损伤,已被记录在案。长期接触苯二氮卓类药物，比如咪达唑仑，与婴儿的神经系统变化有关。尽管尝试使用治疗药物监测以获得最佳镇静剂量，其功效有限。因此,目前正在努力确定替代预测标志物,以指导个体化给药和减轻不良反应.了解这些因素对于确定咪达唑仑未来给药的适用性至关重要，特别是在严重的不良反应之后。本文旨在阐明影响咪达唑仑药代动力学和药效学的因素,可能导致不良事件。最后,我们提供了一个案例研究来举例说明对咪达唑仑相关不良事件的致病因素的复杂调查.
