A discussion about midazolam and lorazepam degradation

February 18, 2013

Does the ambient temperature of your ambulance impact the efficaciousness of your benzodiazepines? How long does it take for midazolam or lorazepam to expire? 

This paper takes a look to see if these two benzodiazepines will become less effective with time and exposure to heat. Midazolam had no degradation, while lorazepam had a slight reduction in concentration. How does your ambulance service store and rotate these medications? What is your second course of action if you administer an ineffective benzodiazepine? The discussion panel also has an informative conversation about clinical significance versus statistical significance.

Article: McMullan, Jason T., Ashley Pinnawin, and Elizabeth Jones. "The 60-day Temperature-dependent Degradation of Midazolam and Lorazepam in the Prehospital Environment." Prehosp Emergency Care 17.1 (2013): n. pag. Print.

Speakers: Keith Wesley, MD, FACEP, Joshua G. Salzman, MA, EMT-B, Marshall J. Washick, BAS, NREMT-P, Bjorn Peterson, MD.