Abstract:
Remimazolam is a novel ultrashort-acting benzodiazepine, which like midazolam, results in sedation, anxiolysis, and amnesia through its agonistic effects on the gamma-amino butyric acid A receptor. As opposed to midazolam, its unique metabolism is via tissue esterases, which results in a rapid elimination with a limited context sensitive half-life and prompt dissipation of its effect when administration is discontinued. Remimazolam received FDA approval for use in adults in 2020. In preliminary and initial clinical trials, its efficacy and safety has been suggested in the adult population, both as a primary agent for procedural sedation or as an adjunct to general anesthesia. There are limited data regarding the use of remimazolam in infants and children and its use in this population remains off label as it does not hold FDA-approval in pediatric-aged patients. This narrative outlines the pharmacologic properties of this unique medication, reviews previous published reports of its role in pediatric-aged patients, and discusses dosing parameters and clinical use in this population.
摘要:
雷米唑仑是一种新型的超短作用苯二氮卓类药物,就像咪达唑仑,镇静的结果,抗焦虑,和健忘症通过其对γ-氨基丁酸A受体的激动作用。相对于咪达唑仑,它独特的代谢是通过组织酯酶,这导致快速消除,具有有限的上下文敏感半衰期,并在停止给药时迅速消散其效果。雷马唑仑于2020年获得FDA批准用于成人。在初步和初步临床试验中,它的有效性和安全性已在成人人群中提出,既可以作为手术镇静的主要药物,也可以作为全身麻醉的辅助药物。关于瑞咪唑仑在婴儿和儿童中使用的数据有限,其在该人群中的使用仍处于标签之外,因为它在儿科老年患者中未获得FDA的批准。这个叙述概述了这种独特药物的药理特性,回顾以前发表的关于其在儿科老年患者中作用的报道,并讨论了该人群的给药参数和临床应用。