Remimazolam (Byfavo) mnemonic
BRIEF
Benzodiazepine
Rapid onset/offset
Induction and maintenance of sedation
Esterase metabolism (leading to inactive metabolites)
For short procedures (30 minutes or less)
Here are some key points about Remimazolam that might be useful for your board exam review:
- General Category: Intravenous benzodiazepine.
- Brand Name: Byfavo (USA), Anerem (Japan), Aptimyda (EU), Ruima (China).
- Chemical Structure: Benzodiazepine derivative.
- Mechanism of Action: Enhances the effect of GABA at the GABA-A receptor, increasing the frequency of chloride channel opening.
- Molecular Formula: C21H19BrN4O2.
- Onset and Duration: Rapid onset and ultrafast offset due to ester hydrolysis.
- Indications: Procedural sedation, induction and maintenance of general anesthesia.
- Dosage: Induction dose of 0.2 mg/kg/min, maintenance dose of 1 mg/kg/h.
- Metabolism/Excretion: Metabolized by tissue esterases, minimal hepatic metabolism, excreted via urine.
- Side Effects: Hypotension, respiratory depression, bradycardia, nausea, vomiting.
- Contraindications/Cautions: Severe respiratory insufficiency, hypersensitivity to benzodiazepines.
- Reversal Agent: Flumazenil.
- Additional Notes: Combines the pharmacokinetics of remifentanil with the pharmacodynamics of midazolam, does not accumulate during long infusions.
For more anesthesiology mnemonics check this mnemonic book.
This post covers the points you need to know for your board exams as well as for teaching residents on the daily rounds. Medical professionals can't use the information here to treat their patients nor people can use the information her to treat themselves. If you are having any medical issues, contact your local emergency services or your primary care provider. Please refer to your doctor for medical advice.