When given via intramuscular injection, which statement is true about midazolam compared with diazepam?

When given via intramuscular injection, which statement is true about midazolam compared with diazepam?

• A. More rapid and predictable onset
• B. Greater thrombophlebitis risk
• C. Longer elimination half-life
• D. Has active metabolites

Answer: (A)

Midazolam given by intramuscular injection reaches the bloodstream more quickly and consistently than diazepam because of how each drug is formulated for IM use. Midazolam is water-soluble in its injectable form, so it is absorbed rapidly from muscle tissue, producing a quick and predictable onset of effect. Diazepam, on the other hand, is highly lipophilic and tends to form a depot at the injection site, leading to slower and more variable absorption and a less predictable onset. The other statements don’t fit IM pharmacokinetics: thrombophlebitis risk is mainly a concern with intravenous administration; diazepam has active metabolites that can prolong effects and contribute to a longer duration, whereas midazolam’s clinically significant metabolites are less impactful.

Midazolam given by intramuscular injection reaches the bloodstream more quickly and consistently than diazepam because of how each drug is formulated for IM use. Midazolam is water-soluble in its injectable form, so it is absorbed rapidly from muscle tissue, producing a quick and predictable onset of effect. Diazepam, on the other hand, is highly lipophilic and tends to form a depot at the injection site, leading to slower and more variable absorption and a less predictable onset.

The other statements don’t fit IM pharmacokinetics: thrombophlebitis risk is mainly a concern with intravenous administration; diazepam has active metabolites that can prolong effects and contribute to a longer duration, whereas midazolam’s clinically significant metabolites are less impactful.