ArticleBritish journal of clinical pharmacology2018
Population pharmacodynamic modelling of midazolam induced sedation in terminally ill adult patients.
Article in British journal of clinical pharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 25 citations in OpenAlex.
- Identification and evaluation of observational measures for the assessment and/or monitoring of level of consciousness in adult palliative care patients: A systematic review for I-CAN-CARE.Palliative medicine · 2020Pooled it
- Incorporating new approach methods (NAMs) data in dose-response assessments: The future is now!Journal of toxicology and environmental health. Part B, Critical reviews · 2025Review
- γ-Aminobutyric acid type A receptor β1 subunit gene polymorphisms are associated with the sedative and amnesic effects of midazolam.Molecular brain · 2024Article
- Remimazolam-Based Anesthesia in Patients with Heart Failure Due to Mitral Regurgitation and Low Left Ventricular Function: A Case Series.Medicina (Kaunas, Lithuania) · 2023Article
- Linking categorical models for prediction of pleasantness score using individual predictions of sweetness and creaminess: An advancement of categorical modeling.Journal of pharmacokinetics and pharmacodynamics · 2021Article
- Sweet/Fat Preference Taste in Subjects Who are Lean, Obese and Very Obese.Pharmaceutical research · 2020Article
- Inflammation is a major regulator of drug metabolizing enzymes and transporters: Consequences for the personalization of drug treatment.Pharmacology & therapeutics · 2020Review
- Influence of muscle mass on the estimation of glomerular filtration rate in Japanese terminal cancer patients.Clinical and experimental nephrology · 2020Observational
- Remimazolam besilate, a benzodiazepine, has been approved for general anesthesia!!Journal of anesthesia · 2020Article
- Midazolam: an essential palliative care drug.Palliative care and social practice · 2020Review
- Palliative Sedation for the Terminally Ill Patient.CNS drugs · 2018Review
- Nonalcoholic Fatty Liver Disease and Diabetes Are Associated with Decreased CYP3A4 Protein Expression and Activity in Human Liver.Molecular pharmaceutics · 2018Article
- Population pharmacodynamic modelling of midazolam induced sedation in terminally ill adult patients.British journal of clinical pharmacology · 2018Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsMidazolam is the drug of choice for palliative sedation and is titrated to achieve the desired level of sedation. A previous pharmacokinetic (PK) study showed that variability between patients could be partly explained by renal function and inflammatory status. The goal of this study was to combine this PK information with pharmacodynamic (PD) data, to evaluate the variability in response to midazolam and to find clinically relevant covariates that may predict PD response.
methodA population PD analysis using nonlinear mixed effect models was performed with data from 43 terminally ill patients. PK profiles were predicted by a previously described PK model and depth of sedation was measured using the Ramsay sedation score. Patient and disease characteristics were evaluated as possible covariates. The final model was evaluated using a visual predictive check.
resultsThe effect of midazolam on the sedation level was best described by a differential odds model including a baseline probability, Emax model and interindividual variability on the overall effect. The EC50 value was 68.7 μg l
conclusionWe were able to describe the clinical response to midazolam accurately. As expected, there was large variability in response to midazolam. The use of haloperidol was associated with a lower probability of sedation. This may be a result of confounding by indication, as haloperidol was used to treat delirium, and deliria has been linked to a more difficult sedation procedure.
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