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6/9/22 dc Midazolam
June 21, 2022
From: "David Collette" <david.collette@hhsys.org>
To: "grp allpharm" <grp_allpharm@hhsys.org>
Sent: Thursday, June 9, 2022 8:55:14 AM
Subject: midazolam
With the recent LORazepam 2 mg injection shortage, we have had some situations where midazolam injection was interchanged and administered in place of LORazepam on a regular unit. Our policy has NOT been changed to allow use of midazolam IV push outside of ICUs procedural areas. If LORazepam IV push is ordered outside of these 2 areas, pharmacists must work with the prescriber to choose an alternate drug that is approved for that area. Depending on the situation, some options for non-ICU, non-procedural areas may include
- oral LORazepam
- alprazolam
- chlordiazepoxide
- diphenhydramine inj
- hydroxyzine inj
- phenobarbital (alcohol withdrawal)
- haloperidol (note restrictions) or ziprasidone or olanzapine (more severe agitation)
Thanks you for helping us work through this shortage and by providing the safest and most effective care for our patients. If you have questions, please call me. DAVID