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midazolam

✓ Approved

Rafa Laboratories Ltd · GABRA1 · Small Molecule

What is midazolam?

midazolam is a small molecule developed by Rafa Laboratories Ltd. It is approved for therapeutic indications via injectable (others) or intramuscular (im) injection.

Drug Profile

CompanyRafa Laboratories Ltd
Drug ClassSmall Molecule
Molecular TargetGABRA1, GABRA2, GABRA3, GABRA4, GABRA5
RouteInjectable (Others), Intramuscular (IM) Injection
StatusApproved
Sources: ClinicalTrials.gov, Rafa Laboratories Ltd

Mechanism of Action

Molecular Targets

midazolam acts on 5 molecular targets:

GABRA1gamma-aminobutyric acid type A receptor alpha1 subunit (DEE19, ECA4)
GABRA2gamma-aminobutyric acid type A receptor alpha2 subunit (DEE78, EIEE78)
GABRA3gamma-aminobutyric acid type A receptor alpha3 subunit (EPILX2)
GABRA4gamma-aminobutyric acid type A receptor alpha4 subunit ()
GABRA5gamma-aminobutyric acid type A receptor alpha5 subunit (EIEE79, DEE79)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

midazolam is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Nervous system disordersStatus epilepticus✓ Approved

Related Research Articles

PubMedPsychopharmacology2026-05-22

Shorter to be effective: subanesthetic-dose ketamine infusion reduces the global and regional path length of brain functional connectivity in patients with treatment-resistant depression and suicidal ideation.

Lin Wei-Chen WC, Cheng Li-Kai LK, Su Tung-Ping TP, Chen Li-Fen LF et al.

Studies have demonstrated that subanesthetic-dose ketamine may modulate the functioning of specific depression-related brain regions, particularly the anterior cingulate cortex and prefrontal cortex. However, how subanesthetic-dose ketamine alters the global and regional graph theory metrics of resting-state functional connectivity in patients with treatment-resistant depression (TRD) and strong suicidal symptoms remains unclear. We conducted a randomized, double-blinded, resting-state functional magnetic resonance imaging clinical trial in patients with TRD and strong suicidal symptoms. These patients received either subanesthetic-dose ketamine (0.5 mg/kg, n = 21) or midazolam (0.045 mg/kg, n = 22). Neuroimaging was performed before infusion and on day 3 after infusion. A graph theory analysis was conducted to calculate global and regional metrics after infusion. Compared with the midazolam group, the ketamine group exhibited a substantially lower mean global path length after infusion. Specifically, in patients who received subanesthetic-dose ketamine treatment, the regional path lengths were decreased in key depression-related brain regions such as the anterior cingulate cortex, posterior cingulate cortex, supplementary motor area, superior parietal lobule, and superior frontal gyrus. Decreased global and regional path lengths suggest improved network integration following subanesthetic-dose ketamine treatment in patients with TRD and strong suicidal symptoms. Further studies are required to validate our findings.

PMID 42168548
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PubMedRevista Cuidarte2026-05-22

Monitoring smart infusion pumps in adult intensive care units.

Narváez-Martínez Mario Andrés MA, Rosas-Santana Andrea A, Rojas-Castañeda Yudy Andrea YA, Zapata-Cristancho Diana Catalina DC

Medication administration in intensive care units is one of the main care activities of nursing professionals. The integration of scientific knowledge, together with the use of technologies such as infusion pumps, enables the reduction of errors and improves the quality of care. To describe the use of an infusion pump monitoring platform for medication administration in adult intensive care units at a university hospital in Bogotá, Colombia. This was an observational, retrospective study that collected 35,738 medication administration records from five intensive care units using a monitoring platform during 2023. A descriptive analysis was performed using frequencies and proportions, along with simple associations assessing compliance between medications and doses. Compliance with the drug library during the first year of the platform was 66%. The platform reported 5,589 hard-limit blocks involving high-alert medications, of which 76% were related to the administration of noradrenaline, midazolam, and fentanyl. The results were consistent with other studies, demonstrating drug library compliance ranging from 65% to 80% during the first year of implementation. The implementation of institutional medication administration monitoring programs, using technologies integrated into infusion pumps, positively impacts patient safety, reduces costs associated with care, and continuous improvement within institutions.

PMID 42169983
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PubMedThe pharmacogenomics journal2026-05-22

Impact of population-specific pharmacogenomic variants on drug dosing in ICU patients.

Rostami Mahboubeh R MR, Rodriguez-Flores Juan J, Ait Hssain Ali A, Al Shakaki Alya A et al.

Intensive care units (ICU) patients are highly vulnerable to inaccurate drug dosing. Pharmacogenomics (PGx) studies the role of inherited genetic variation in drug metabolism and dose efficacy. To assess the prevalence of PGx variants that may influence therapeutic effect in the ICU, we carried out whole genome sequencing (WGS) of 210 Qataris in ICU care at Hamad Medical Corporation (HMC), Doha, Qatar and assessed the WGS for predicted deleterious variants of genes that metabolize 30 drugs commonly prescribed in the ICU. PGx variation was evaluated using two complementary approaches. First, variants with established functional interpretation were assessed using CPIC guidelines and star-allele haplotypes inferred by PharmCAT to estimate the prevalence of alleles associated with abnormal drug metabolism. Second, a broader exploratory analysis examined computationally predicted deleterious single-nucleotide variants in pharmacogenes that currently lack CPIC guidelines or defined star alleles, with these findings interpreted as descriptive of genomic variation rather than clinical metabolizer phenotypes.Of the ICU patients that received the 5 most commonly prescribed drugs (warfarin, phenytoin, midazolam, vancomycin, levetiracetam), 93% had deleterious metabolism-related variants. Ninety-one % of ICU patients carried at least one variant in a gene with known PGx relevance that could potentially impact the metabolism or activity of at least one medication they received. Most patients had ≥14 deleterious variants of genes that affect the metabolism of administered drugs. Comparison of the deleterious variants related to metabolism of ICU drugs with African/African American and European populations revealed significant population specificity in ICU related PGx variants. Together, these data suggest that population specific, PGx based on the individual's genome likely plays a significant role in effective, safe dosing in the ICU setting.

PMID 42168146
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PubMedThe Turkish journal of pediatrics2026-05-22

Pediatric pulmonologists' current practices and variations in flexible bronchoscopy: a national survey study from Türkiye.

Ocak Ece E, Başaran Erdem E, Çakır Erkan E, Çobanoğlu Nazan N et al.

Flexible bronchoscopy (FB) is a critical diagnostic and therapeutic tool in respiratory diseases, enabling airway assessment, sample collection, and therapeutic interventions. Despite international guidelines, practices vary widely across centers. This study aimed to assess current FB practices and to identify variations among pediatric pulmonologists in Türkiye. A descriptive cross-sectional survey was distributed via email to clinical directors of 19 centers performing FB in March 2023. The survey comprised 80 questions across seven domains: demographics, patient preparation, bronchoscopy procedure, sedation/anesthesia, discharge, bronchoscope cleaning, and respondent comments. Participants were asked to provide accurate and objective data on FB practices at their centers. All 19 centers participated in the survey, achieving a 100% response rate. The median FB experience was 12.5 years (IQR: 1-30), with a median 210 procedures per year per center (min-max: 30-500; IQR: 80-250). The most frequently reported indications were atelectasis (84.2%), bronchiectasis (78.9%), suspected foreign body aspiration (52.6%), and to obtain bronchoalveolar lavage (BAL) in patients with immunodeficiency (52.6%). Nine centers (47.4%) indicated performing advanced bronchoscopic procedures, including endobronchial biopsy (31.6%), bronchoscopic intubations (26.3%), and tracheal/bronchial stent insertion (10.5%). General anesthesia (84.2%) was the predominant sedation method, and propofol (89.5%) the most frequently used agent. Premedication was used in 13 centers (68.4%), with midazolam being the most commonly used agent (76.9%). Twelve centers (63.2%) also used topical lidocaine for local anesthesia. Respondents reported the need for developing interventional procedures and increasing the number of trained bronchoscopy teams. This first comprehensive national survey of pediatric FB practices in Türkiye, encompassing all relevant centers, revealed significant heterogeneity in procedural approaches, particularly regarding sedation protocols, BAL techniques, and interventional capabilities. The findings underscore the importance of developing interventional procedures and enhancing the training of pediatric pulmonologists and interdisciplinary teams practicing pediatric bronchoscopy to improve patient outcomes and procedural consistency.

PMID 42172461
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PubMedScientific reports2026-05-21

Effect of ketamine intervention on hemodynamic responses in patients with treatment-resistant depression.

She Guan-Jie GJ, Li Wei-Chi WC, Chou Chun-Hsiang CH, Cheng Li-Kai LK et al.

Emerging evidence shows that ketamine, an N-methyl-D-aspartate (NMDA) receptor antagonist, can produce rapid anti-suicidal effects in treatment-resistant depression, yet its underlying neuropharmacological mechanisms remain elusive. The present study aimed at investigating the therapeutic effect of ketamine infusion on suicidal ideation by examining hemodynamic response changes in resting-state fMRI (rsfMRI) data. We analyzed data from clinical trials involving 45 patients with treatment-resistant depression, including either ketamine (N = 21) or midazolam (N = 24). T1-weighted images and rsfMRI data were collected before and three days after treatment. Three parameters, including response height (RH), time-to-peak (TTP), and full-width at half-maximum (FWHM), were extracted. Results showed that ketamine significantly altered TTP and FWHM in the bilateral olfactory cortex and right inferior parietal gyrus. Changes in TTP and FWHM within the thalamus and superior frontal gyrus were associated with improvements in suicidal ideation. Additionally, ketamine responders exhibited reduced TTP in the left precuneus. These findings suggest that ketamine induces region-specific HRF modulations in brain regions implicated in sensory-cognitive integration, mood regulation, and cognitive control. This supports a broader model in which ketamine's neuropharmacological effects may be understood through the lens of neurovascular coupling dynamics.

PMID 42162047
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PubMedPloS one2026-05-21

Comparison between two different concentrations of ropivacaine in pericapsular nerve group block for patients undergoing total hip arthroplasty: A randomized clinical trial.

Sun Chenxu C, Sun Zhihua Z, Liu Dawei D, Chen Dawei D et al.

Effective pain control during spinal anesthesia positioning remains a clinical challenge in elderly patients undergoing total hip arthroplasty. The pericapsular nerve group block, a novel ultrasound-guided regional anesthesia technique, has shown promise for alleviating hip pain, yet the optimal concentration of local anesthetics for this approach remains unclear. In this randomized, observer-blinded clinical trial involving 102 patients, we compared the analgesic efficacy of two concentrations of ropivacaine (0.375% vs. 0.5%) administered via pericapsular nerve group block prior to spinal anesthesia. Patients receiving 0.5% ropivacaine reported significantly lower pain scores during positioning and demonstrated prolonged postoperative analgesia up to 48 hours, without a corresponding increase in adverse events. Both concentrations improved positioning quality, reduced opioid requirements, and enhanced recovery compared to controls who received standard intravenous analgesic supplementation (including preoperative midazolam and ketorolac, and postoperative sufentanil PCA), though the higher concentration yielded modest additional benefits. These findings suggest that a 0.5% ropivacaine pericapsular nerve group block may offer superior perioperative analgesia for hip arthroplasty without compromising safety, while highlighting the need to balance analgesic potency with potential motor effects. This study informs optimization of nerve block protocols to improve perioperative outcomes in a high-risk surgical population. This study informs optimization of nerve block protocols to improve perioperative outcomes in a high-risk surgical population. The trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR2400089440).

PMID 42166434
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