Biomaterial Database

Severe withdrawal syndrome possibly associated with cessation of a midazolam and fentanyl infusion. 1995

M P Ducharme, and P Munzenberger

Faculty of Pharmacy, University of Montréal, Québec, Canada.

A 40-month-old child was sedated with a fentanyl and midazolam infusion for 7 days. After the drugs were discontinued he became unresponsive and globally aphasic, and had marked thrombocytosis. He was hospitalized for 4 weeks, during which time his motor and cognitive status slowly improved, and had almost returned to baseline at time of discharge. Severe neurologic abnormalities have been reported with midazolam and fentanyl, administered separately or together, and seem to be a consequence of a withdrawal syndrome. Of interest, this patient had a reactive thrombocytosis at the time of onset of the withdrawal syndrome, and his decreased platelet count coincided with the return to normal cognitive and motor status. Based on this experience and other reports, we believe midazolam-fentanyl combination should be administered with caution.

UI	MeSH Term	Description	Entries
D006993	Hypnotics and Sedatives	Drugs used to induce drowsiness or sleep or to reduce psychological excitement or anxiety.	Hypnotic,Sedative,Sedative and Hypnotic,Sedatives,Hypnotic Effect,Hypnotic Effects,Hypnotics,Sedative Effect,Sedative Effects,Sedatives and Hypnotics,Effect, Hypnotic,Effect, Sedative,Effects, Hypnotic,Effects, Sedative,Hypnotic and Sedative
D007262	Infusions, Intravenous	The long-term (minutes to hours) administration of a fluid into the vein through venipuncture, either by letting the fluid flow by gravity or by pumping it.	Drip Infusions,Intravenous Drip,Intravenous Infusions,Drip Infusion,Drip, Intravenous,Infusion, Drip,Infusion, Intravenous,Infusions, Drip,Intravenous Infusion
D008297	Male		Males
D008874	Midazolam	A short-acting hypnotic-sedative drug with anxiolytic and amnestic properties. It is used in dentistry, cardiac surgery, endoscopic procedures, as preanesthetic medication, and as an adjunct to local anesthesia. The short duration and cardiorespiratory stability makes it useful in poor-risk, elderly, and cardiac patients. It is water-soluble at pH less than 4 and lipid-soluble at physiological pH.	Dormicum,Midazolam Hydrochloride,Midazolam Maleate,Ro 21-3981,Versed,Hydrochloride, Midazolam,Maleate, Midazolam,Ro 21 3981,Ro 213981
D002675	Child, Preschool	A child between the ages of 2 and 5.	Children, Preschool,Preschool Child,Preschool Children
D005283	Fentanyl	A potent narcotic analgesic, abuse of which leads to habituation or addiction. It is primarily a mu-opioid agonist. Fentanyl is also used as an adjunct to general anesthetics, and as an anesthetic for induction and maintenance. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1078)	Phentanyl,Duragesic,Durogesic,Fentanest,Fentanyl Citrate,Fentora,R-4263,Sublimaze,Transmucosal Oral Fentanyl Citrate,R 4263,R4263
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001037	Aphasia	A cognitive disorder marked by an impaired ability to comprehend or express language in its written or spoken form. This condition is caused by diseases which affect the language areas of the dominant hemisphere. Clinical features are used to classify the various subtypes of this condition. General categories include receptive, expressive, and mixed forms of aphasia.	Aphasia, Acquired,Dysphasia,Word Deafness,Alogia,Anepia,Aphasia, Ageusic,Aphasia, Auditory Discriminatory,Aphasia, Commisural,Aphasia, Functional,Aphasia, Global,Aphasia, Graphomotor,Aphasia, Intellectual,Aphasia, Mixed,Aphasia, Post-Ictal,Aphasia, Post-Traumatic,Aphasia, Progressive,Aphasia, Semantic,Aphasia, Syntactical,Dejerine-Lichtheim Phenomenon,Dysphasia, Global,Lichtheim's Sign,Logagnosia,Logamnesia,Logasthenia,Acquired Aphasia,Ageusic Aphasia,Ageusic Aphasias,Alogias,Anepias,Aphasia, Post Ictal,Aphasia, Post Traumatic,Aphasias, Commisural,Auditory Discriminatory Aphasia,Auditory Discriminatory Aphasias,Commisural Aphasia,Commisural Aphasias,Deafness, Word,Dejerine Lichtheim Phenomenon,Discriminatory Aphasia, Auditory,Discriminatory Aphasias, Auditory,Functional Aphasia,Functional Aphasias,Global Aphasia,Global Aphasias,Global Dysphasia,Global Dysphasias,Graphomotor Aphasia,Graphomotor Aphasias,Intellectual Aphasia,Intellectual Aphasias,Lichtheim Sign,Lichtheims Sign,Logagnosias,Logamnesias,Logasthenias,Mixed Aphasia,Mixed Aphasias,Phenomenon, Dejerine-Lichtheim,Post-Ictal Aphasia,Post-Ictal Aphasias,Post-Traumatic Aphasia,Post-Traumatic Aphasias,Progressive Aphasia,Progressive Aphasias,Semantic Aphasia,Semantic Aphasias,Sign, Lichtheim's,Syntactical Aphasia,Syntactical Aphasias
D013375	Substance Withdrawal Syndrome	Physiological and psychological symptoms associated with withdrawal from the use of a drug after prolonged administration or habituation. The concept includes withdrawal from smoking or drinking, as well as withdrawal from an administered drug.	Drug Withdrawal Symptoms,Withdrawal Symptoms,Drug Withdrawal Symptom,Substance Withdrawal Syndromes,Symptom, Drug Withdrawal,Symptom, Withdrawal,Symptoms, Drug Withdrawal,Symptoms, Withdrawal,Syndrome, Substance Withdrawal,Syndromes, Substance Withdrawal,Withdrawal Symptom,Withdrawal Symptom, Drug,Withdrawal Symptoms, Drug,Withdrawal Syndrome, Substance,Withdrawal Syndromes, Substance
D013922	Thrombocytosis	Increased numbers of platelets in the peripheral blood. (Dorland, 27th ed)	Thrombocythemia,Thrombocythemias,Thrombocytoses