{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:54:32Z","timestamp":1761710072296,"version":"3.44.0"},"reference-count":21,"publisher":"The Pediatric Pharmacy Association","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023]]},"abstract":"<jats:p>Midazolam is a commonly used, well-tolerated, anxiolytic, sedative, anesthesia induction agent, and an adjunct for procedural sedation that is used widely in the emergency department. The ability to administer midazolam via multiple routes, including intranasal, makes it a particularly common choice for use in children. Intranasal administration is safe, easy, and well tolerated and has been shown to be an effective method of obtaining anxiolysis and\/or sedation. Adverse drug reactions, including allergic reactions, can occur with any medication. However, anaphylaxis is an uncommon phenomenon from midazolam. Despite being one of the most common medications used in the emergency department and operating room, there are only a handful of unequivocal cases of anaphylaxis secondary to midazolam. The rarity of this presentation may lead to delays in care and potential adverse outcomes as a result. We present one such case of a 10-year-old patient who experienced anaphylaxis after administration of intranasal midazolam to facilitate a computed tomography scan.<\/jats:p>","DOI":"10.5863\/1551-6776-28.7.658","type":"journal-article","created":{"date-parts":[[2023,11,28]],"date-time":"2023-11-28T08:59:00Z","timestamp":1701161940000},"page":"658-661","source":"Crossref","is-referenced-by-count":2,"title":["An Unusual Case of Delayed Midazolam Anaphylaxis and a Review of the Current Literature"],"prefix":"10.5863","volume":"28","author":[{"given":"Nicholas C.","family":"Cochran-Caggiano","sequence":"first","affiliation":[{"name":"Upstate University Hospital, Department of Emergency Medicine, Syracuse, NY (NCC, DM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Mann","sequence":"additional","affiliation":[{"name":"Upstate University Hospital, Department of Emergency Medicine, Syracuse, NY (NCC, DM)"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Aiello","sequence":"additional","affiliation":[{"name":"Division of Pediatric Emergency Medicine (PA), Department of Emergency Medicine, Upstate University Hospital, Syracuse, NY"},{"name":"Department of Pharmacy (PA), Upstate University Hospital, Syracuse, NY"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3883","reference":[{"issue":"(1)","key":"i2331-348X-28-7-658-b1","series-title":"Eur Rev Med Pharmacol Sci","first-page":"217","article-title":"Intranasal drug administration for procedural sedation in children admitted to pediatric emergency room","volume":"22","author":"Fantacci","year":"2018","unstructured":"Fantacci\n              C\n            , FabrizioGC, FerraraP,\n          . Intranasal drug administration for procedural sedation in children admitted to pediatric emergency room. Eur Rev Med Pharmacol Sci. 2018;22(1):217\u20132s22."},{"key":"i2331-348X-28-7-658-b2","series-title":"Epilepsy Res","first-page":"106567","article-title":"Clinical pharmacokinetic and pharmacodynamic profile of midazolam nasal spray","volume":"171","author":"Bouw","year":"2021","unstructured":"Bouw\n              MR\n            , ChungSS, GidalB,\n          . Clinical pharmacokinetic and pharmacodynamic profile of midazolam nasal spray. Epilepsy Res. 2021;171:106567."},{"issue":"(3)","key":"i2331-348X-28-7-658-b3","series-title":"Anesth Prog","first-page":"160","article-title":"Benzodiazepine allergy with anesthesia administration: a review of current literature","volume":"63","author":"Haybarger","year":"2016","unstructured":"Haybarger\n              E\n            , YoungAS, GiovannittiJA. Benzodiazepine allergy with anesthesia administration: a review of current literature. Anesth Prog. 2016;63(3):160\u2013167."},{"issue":"(4)","key":"i2331-348X-28-7-658-b4","series-title":"Anesth Analg","first-page":"811","article-title":"Anaphylactoid reaction to midazolam","volume":"79","author":"Fujita","year":"1994","unstructured":"Fujita\n              Y\n            , IshikawaH, YokotaK. Anaphylactoid reaction to midazolam. Anesth Analg. 1994;79(4):811\u2013812."},{"issue":"(2)","key":"i2331-348X-28-7-658-b5","series-title":"J Allergy Clin Immunol","first-page":"366","article-title":"Anaphylaxis during anesthesia in France: an 8-year national survey","volume":"128","author":"Mertes","year":"2011","unstructured":"Mertes\n              PM\n            , AllaF, Tr\u00e9chotP,\n          . Anaphylaxis during anesthesia in France: an 8-year national survey. J Allergy Clin Immunol. 2011;128(2):366\u2013373."},{"issue":"(5)","key":"i2331-348X-28-7-658-b6","series-title":"Anesth Analg","first-page":"1202","article-title":"Allergic reactions during anesthesia at a large United States referral center","volume":"113","author":"Gurrieri","year":"2011","unstructured":"Gurrieri\n              C\n            , WeingartenTN, MartinDP,\n          . Allergic reactions during anesthesia at a large United States referral center. Anesth Analg. 2011;113(5):1202\u20131212."},{"issue":"(4)","key":"i2331-348X-28-7-658-b7","series-title":"Paediatr Anaesth","first-page":"436","article-title":"Perioperative hypersensitivity reactions during childhood and outcomes of subsequent anesthesia","volume":"31","author":"Karaatmaca","year":"2021","unstructured":"Karaatmaca\n              B\n            , SahinerUM, SekerelBE,\n          . Perioperative hypersensitivity reactions during childhood and outcomes of subsequent anesthesia. Paediatr Anaesth. 2021;31(4):436\u2013443."},{"issue":"(1)","key":"i2331-348X-28-7-658-b8","series-title":"J Allergy Clin Immunol Pract","first-page":"101","article-title":"Antibiotics are an important identifiable cause of perioperative anaphylaxis in the United States","volume":"3","author":"Gonzalez-Estrada","year":"2015","unstructured":"Gonzalez-Estrada\n              A\n            , PienLC, ZellK,\n          . Antibiotics are an important identifiable cause of perioperative anaphylaxis in the United States. J Allergy Clin Immunol Pract. 2015;3(1):101\u2013105.e1."},{"issue":"(10)","key":"i2331-348X-28-7-658-b9","series-title":"Allergy","first-page":"1872","article-title":"An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions","volume":"74","author":"Garvey","year":"2019","unstructured":"Garvey\n              LH\n            , EboDG, MertesPM,\n          . An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions. Allergy. 2019;74(10):1872\u20131884."},{"issue":"(3)","key":"i2331-348X-28-7-658-b10","series-title":"Turk Pediatri Ars","first-page":"200","article-title":"Anaphylaxis with midazolam in pediatric hematology-oncology unit: a case report","volume":"53","author":"\u00c7akmakc\u0131","year":"2018","unstructured":"\u00c7akmakc\u0131\n              S\n            , BayhanT, CihanMK,\n          . Anaphylaxis with midazolam in pediatric hematology-oncology unit: a case report. Turk Pediatri Ars. 2018;53(3):200\u2013201."},{"issue":"(3)","key":"i2331-348X-28-7-658-b11","series-title":"Clin Endosc","first-page":"262","article-title":"A case of midazolam anaphylaxis","volume":"47","author":"Shin","year":"2014","unstructured":"Shin\n              JG\n            , HwangJH, LeeBS,\n          . A case of midazolam anaphylaxis. Clin Endosc. 2014;47(3):262\u2013265."},{"issue":"(4)","key":"i2331-348X-28-7-658-b12","series-title":"Allergol Immunopathol (Madr)","first-page":"167","article-title":"Allergic reactions to midazolam: a case series from an Italian allergy unit","volume":"49","author":"Nucera","year":"2021","unstructured":"Nucera\n              E\n            , ParrinelloG, BuonomoA,\n          . Allergic reactions to midazolam: a case series from an Italian allergy unit. Allergol Immunopathol (Madr). 2021;49(4):167\u2013170."},{"issue":"(3)","key":"i2331-348X-28-7-658-b13","series-title":"Anesthesiology","first-page":"310","article-title":"Midazolam: pharmacology and uses","volume":"62","author":"Reves","year":"1985","unstructured":"Reves\n              JG\n            , FragenRJ, VinikHR,\n          . Midazolam: pharmacology and uses. 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Accessed November 11, 2022. https:\/\/www.pfizermedicalinformation.com\/en-us\/midazolam-2\/description"}],"container-title":["The Journal of Pediatric Pharmacology and Therapeutics"],"original-title":[],"link":[{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/7\/article-p658.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/meridian.allenpress.com\/jppt\/article-pdf\/28\/7\/658\/3292980\/i2331-348x-28-7-658.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/7\/article-p658.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/jppt.kglmeridian.com\/downloadpdf\/journals\/jppt\/28\/7\/article-p658.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:48:55Z","timestamp":1747356535000},"score":1,"resource":{"primary":{"URL":"https:\/\/jppt.kglmeridian.com\/view\/journals\/jppt\/28\/7\/article-p658.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023]]},"references-count":21,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.5863\/1551-6776-28.7.658","relation":{},"ISSN":["2331-348X","1551-6776"],"issn-type":[{"type":"electronic","value":"2331-348X"},{"type":"print","value":"1551-6776"}],"subject":[],"published":{"date-parts":[[2023]]}}}