MODERATE SEDATION COMPREHENSIVE 2026 QUESTIONS
AND ANSWERS RATED A+
✔✔Midazolam (Versed) Contraindications - ✔✔- Acute narrow-angle glaucoma
-Shock
✔✔Midazolam (Versed) Adverse Reactions - ✔✔- Respiratory depression
- Apnea
- Cardiac Arrest
- Coughing
- Bronchospasm
- Laryngospasm
- Hypotension
- PVC
- Tachycardia or bradycardia
- Hiccups
- N/V
- Urticaria
- Pain at infusion site
✔✔Midazolam (Versed) IV - ✔✔-Onset of action is 1 minute
-Peak effect seen in 3-4 minutes
-Durations of Action 15-80 minutes
✔✔Midazolam (Versed) IM - ✔✔-Onset 5-15 minutes
-Peak 15-60 minutes
-Lasts 2-6 hours
✔✔Midazolam (Versed) PO - ✔✔-Onset 10-20 minutes (usually less than 10 minutes)
-Peak 30 minutes
-Lasts 2-6h
✔✔Diazepam (Valium) Considerations - ✔✔-Not compatible with other agents as it
easily precipitates
-Painful upon injection
-Long half life due to metabolites
✔✔Diazepam (Valium) Adult Dose - ✔✔-Administer in 1-2 mg increments every 2
minutes IV until desired effect--slurred speech--achieved
-Generally 10-20mg in 60 minutes
✔✔Diazepam (Valium) Pediatric Dose - ✔✔0.1 to 0.3 mg/kg
✔✔Diazepam (Valium) IV - ✔✔-Onset 1 to 5 minutes
-Peaks in 3 to 5 minutes
,-Lasts 2 to 4 hours
✔✔Diazepam (Valium) PO - ✔✔-Onset 15 to 60 min.
-Peaks in 60 minutes
-Lasts 3 to 6 hours
✔✔Diazepam (Valium) Potential Adverse Reactions - ✔✔-Phlebitis at injection site
-Bradycardia
-Hypotension
-Respiratory depression and apnea
-Agitation
-Confusion
-Hiccups
-Diplopia
-Rash
-Urticaria
-Vesicant
✔✔Flumazenil (Romazicon) - ✔✔-Reversal for Benzodiazepines as it is the specific
benzo antagonist
-Reverses sedation, respiratory depression, amnesia
-Peak effect in 6-10 min.
✔✔Romazicon Administration Technique IV Bolus - ✔✔-Initial dose of 0.2mg
-Phase One: 0.2mg IV over 15 seconds to 1 min
-Phase Two: If patient does not reach desired level of consciousness after 45 seconds,
repeat dose at one minute intervals until a cumulative dose of 1 mg has been given
-80% of the max response is seen in 3 minutes
*Anesthesia should be consulted if no desired clinical response with the administration
of the initial 1 mg dose*
✔✔Romazicon Administration Technique IV infusion - ✔✔30-60 mcg/minute (0.5-1
mcg/kg/min)
Total dose not to exceed 3mg/h
✔✔Romazicon IV Onset, Peak, Duration - ✔✔-Onset 1 to 2 minutes
- Peak effect 6 to 10 minutes
- Lasts 45-90 minutes
✔✔Romazicon Potential Adverse Reactions - ✔✔- N/V; sweating; hot flashes; agitation;
HA; injection site pain
-DO NOT use in patient's who chronically take benzodiazepines
-May cause tremors, profuse sweating, hypotension, seizure activity
*Caution in patients with seizure disorders as it may reverse the effects of anti-seizure
medications
, ✔✔Romazicon via IV bolus or infusion - ✔✔-Onset 1 to 2 minutes
-Peaks 6-10 minutes with 80% of the max response seen within 3 minutes
-Lasts 45 to 90 minutes
✔✔Romazicon Overdose - ✔✔- Excessive doses result in anxiety, agitation, increased
muscle tone, possible convulsions
✔✔Romazicon Adverse Effects - ✔✔-Return of respiratory depression which has
exceeded the therapeutic effects of flumazenil
-Cutaneous vasodilation
-Sweating
-Flushing
-Dysrhythmias
-Bradycardia or tachycardia
-HTN
✔✔Opioids Effects - ✔✔-Analgesia and sedation
-NO amnestic effects
✔✔Opioid Adverse Reactions - ✔✔-Respiratory depression
-N/V
-Pruritus, urticarial
-Urinary retention in young males
-Constipation
✔✔Morphine IV - ✔✔-Onset is less than 1 minutes
-Peak is seen in 5-20 minutes
-Lasts 4 to 7 hours
-Max dose is 0.15mg/kg
✔✔Morphine IM - ✔✔-Onset in 20-60 minutes
-Peaks in 30-60 minutes
-Lasts 4-7 hours
✔✔Morphine PO - ✔✔-Onset within 1 hour
-Peak in 1 to 2 hours
-Lasts 6 to 12 hours
✔✔Morphine Adult Dosage/Administration - ✔✔-Give 2 to 10 mg IV
-Total Dosage of 10 mg in 60 minutes
-Give slowly; titrate to individual response (Q15min)
-Dilute with 5ml of sterile water/NS
✔✔Morphine Pediatric Dosage/Administration - ✔✔-0.05-0.1 mg/kg IV
AND ANSWERS RATED A+
✔✔Midazolam (Versed) Contraindications - ✔✔- Acute narrow-angle glaucoma
-Shock
✔✔Midazolam (Versed) Adverse Reactions - ✔✔- Respiratory depression
- Apnea
- Cardiac Arrest
- Coughing
- Bronchospasm
- Laryngospasm
- Hypotension
- PVC
- Tachycardia or bradycardia
- Hiccups
- N/V
- Urticaria
- Pain at infusion site
✔✔Midazolam (Versed) IV - ✔✔-Onset of action is 1 minute
-Peak effect seen in 3-4 minutes
-Durations of Action 15-80 minutes
✔✔Midazolam (Versed) IM - ✔✔-Onset 5-15 minutes
-Peak 15-60 minutes
-Lasts 2-6 hours
✔✔Midazolam (Versed) PO - ✔✔-Onset 10-20 minutes (usually less than 10 minutes)
-Peak 30 minutes
-Lasts 2-6h
✔✔Diazepam (Valium) Considerations - ✔✔-Not compatible with other agents as it
easily precipitates
-Painful upon injection
-Long half life due to metabolites
✔✔Diazepam (Valium) Adult Dose - ✔✔-Administer in 1-2 mg increments every 2
minutes IV until desired effect--slurred speech--achieved
-Generally 10-20mg in 60 minutes
✔✔Diazepam (Valium) Pediatric Dose - ✔✔0.1 to 0.3 mg/kg
✔✔Diazepam (Valium) IV - ✔✔-Onset 1 to 5 minutes
-Peaks in 3 to 5 minutes
,-Lasts 2 to 4 hours
✔✔Diazepam (Valium) PO - ✔✔-Onset 15 to 60 min.
-Peaks in 60 minutes
-Lasts 3 to 6 hours
✔✔Diazepam (Valium) Potential Adverse Reactions - ✔✔-Phlebitis at injection site
-Bradycardia
-Hypotension
-Respiratory depression and apnea
-Agitation
-Confusion
-Hiccups
-Diplopia
-Rash
-Urticaria
-Vesicant
✔✔Flumazenil (Romazicon) - ✔✔-Reversal for Benzodiazepines as it is the specific
benzo antagonist
-Reverses sedation, respiratory depression, amnesia
-Peak effect in 6-10 min.
✔✔Romazicon Administration Technique IV Bolus - ✔✔-Initial dose of 0.2mg
-Phase One: 0.2mg IV over 15 seconds to 1 min
-Phase Two: If patient does not reach desired level of consciousness after 45 seconds,
repeat dose at one minute intervals until a cumulative dose of 1 mg has been given
-80% of the max response is seen in 3 minutes
*Anesthesia should be consulted if no desired clinical response with the administration
of the initial 1 mg dose*
✔✔Romazicon Administration Technique IV infusion - ✔✔30-60 mcg/minute (0.5-1
mcg/kg/min)
Total dose not to exceed 3mg/h
✔✔Romazicon IV Onset, Peak, Duration - ✔✔-Onset 1 to 2 minutes
- Peak effect 6 to 10 minutes
- Lasts 45-90 minutes
✔✔Romazicon Potential Adverse Reactions - ✔✔- N/V; sweating; hot flashes; agitation;
HA; injection site pain
-DO NOT use in patient's who chronically take benzodiazepines
-May cause tremors, profuse sweating, hypotension, seizure activity
*Caution in patients with seizure disorders as it may reverse the effects of anti-seizure
medications
, ✔✔Romazicon via IV bolus or infusion - ✔✔-Onset 1 to 2 minutes
-Peaks 6-10 minutes with 80% of the max response seen within 3 minutes
-Lasts 45 to 90 minutes
✔✔Romazicon Overdose - ✔✔- Excessive doses result in anxiety, agitation, increased
muscle tone, possible convulsions
✔✔Romazicon Adverse Effects - ✔✔-Return of respiratory depression which has
exceeded the therapeutic effects of flumazenil
-Cutaneous vasodilation
-Sweating
-Flushing
-Dysrhythmias
-Bradycardia or tachycardia
-HTN
✔✔Opioids Effects - ✔✔-Analgesia and sedation
-NO amnestic effects
✔✔Opioid Adverse Reactions - ✔✔-Respiratory depression
-N/V
-Pruritus, urticarial
-Urinary retention in young males
-Constipation
✔✔Morphine IV - ✔✔-Onset is less than 1 minutes
-Peak is seen in 5-20 minutes
-Lasts 4 to 7 hours
-Max dose is 0.15mg/kg
✔✔Morphine IM - ✔✔-Onset in 20-60 minutes
-Peaks in 30-60 minutes
-Lasts 4-7 hours
✔✔Morphine PO - ✔✔-Onset within 1 hour
-Peak in 1 to 2 hours
-Lasts 6 to 12 hours
✔✔Morphine Adult Dosage/Administration - ✔✔-Give 2 to 10 mg IV
-Total Dosage of 10 mg in 60 minutes
-Give slowly; titrate to individual response (Q15min)
-Dilute with 5ml of sterile water/NS
✔✔Morphine Pediatric Dosage/Administration - ✔✔-0.05-0.1 mg/kg IV
