Adverse Drug Reaction with Midazolam Use in Emergency Department
Midazolam Use in Emergency Department
Abstract
Midazolam is one of the most commonly used drugs for sedation in Emergency Department (ED). This was a retrospective study conducted on 380 patients from December 2012 to May 2014 in ED of Universiti Kebangsaan Malaysia Medical Centre (UKMMC). The objective was to elicit the frequency of side effects and correlation to various factors i.e. socio-demography, co-morbidities, age groups and underlying illnesses. Out of 380 patients, 35 patients experienced side effects (20 patients with midazolam alone, 15 patients with combination of drugs). The average age was 42 years and the average dose of midazolam was 3.5mg. The most common other drug combined was fentanyl. The overall complication rate for midazolam was 5.3%. The most common side effect recorded was excessive somnolence (1.6%). Other side effects included local skin reactions (1.1%), vomiting (0.8%), headache (0.8%) and hypotension (0.5%). There was no significant association between the socio-demographic factors and drugs combination with the side effects of midazolam on patients. It was concluded that midazolam was a safe drug due to absence of any life-threatening side effects. There are possibilities that most side effects recorded could be caused by other comfounding factors e.g. underlying injuries or disease and combination with other drugs.
Keywords :
excessive somnolence,
headache,
hypotension,
local skin reaction,
Midazolam,
vomit,
Abstrak
Midazolam adalah salah satu ubat yang paling biasa digunakan sebagai ubat pelali di Jabatan Kecemasan (ED). Ini adalah satu kajian retrospektif yang dijalankan ke atas 380 pesakit dari Disember 2012 hingga Mei 2014 di ED, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Objektifnya adalah untuk mendapatkan kekerapan kesan sampingan dan korelasi kepada pelbagai faktor iaitu sosio-demografi, kumpulan umur dan penyakit-penyakit utama. Daripada 380 pesakit, 35 pesakit mempunyai kesan sampingan (20 pesakit dengan midazolam sahaja, 15 pesakit dengan kombinasi ubat-ubatan). Umur purata adalah 42 tahun dan dos purata midazolam adalah 3.5mg. Ubat lain yang paling biasa di gabung adalah fentanyl. Kadar komplikasi keseluruhan midazolam adalah 5.3%. Kesan sampingan yang paling biasa yang dicatatkan adalah somnolen (1.6%). Kesan sampingan yang lain adalah reaksi alergi kulit (1.1%), muntah (0.8%), sakit kepala (0.8%) dan tekanan darah rendah (0.5%). Tidak ada hubungan yang signifikan antara faktor-faktor sosio-demografi dan kombinasi ubat-ubatan dengan kesan sampingan midazolam pada pesakit. Kesimpulan daripada kajian ini ialah midazolam adalah dadah yang sangat selamat kerana ia tiada kesan sampingan yang mengancam nyawa. Terdapat kemungkinan bahawa kesan-kesan sampingan direkodkan boleh disebabkan oleh faktor-faktor lain seperti kecederaan atau penyakit dan kombinasi dengan ubat-ubatan lain.
Kata Kunci :
Midazolam,
muntah,
reaksi alahan kulit,
sakit kepala,
somnolen,
tekanan darah rendah,
Correspondance Address
Nik Azlan Nik Muhamad, Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Tel: +60391455703 Fax: +60391456577 Email: nikazlanmuhamad@hotmail.com
