Midazolam is a commonly used benzodiazepine in palliative care and is consideredone of the four essential drugs needed for the promotion of quality care in dying patients.Acting on the benzodiazepine receptor, it promotes the action of gamma-aminobutyric acid.Gamma-aminobutyric acid action promotes sedative, anxiolytic, and anticonvulsant properties.Midazolam has a faster onset and shorter duration of action than other benzodiazepinessuch as diazepam and lorazepam lending itself to greater flexibility in dosing than otherbenzodiazepines. The kidneys excrete midazolam and its active metabolite. Metabolism occursin the liver by the P450 system. This article examines the pharmacology, pharmacodynamics,and clinical uses of midazolam in palliative care.
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