The two forms are interchangeable formed by the loss (red) or addition of water (green) of water to the molecule. The closed (shown on the left) and open (shown on the right) forms of Versed are in equilibrium, depending on pH. Versed's ability to come back together is due to a reversible opening of the benzodiazepine ring (blue circle). Versed is a Jekyll/Hyde drug- it has two personalities only one of which is good (6). Once this conversion happens, the molecule doesn't get put back together again (5), but Versed does just that. Following administration, almost all small molecule drugs are chemically altered (metabolized), mostly by the liver, and converted to inactive compounds (4) which are then excreted. There are some exceptions to this (see note 3). Most small molecule drugs (2) are single entities containing one medicine that does (hopefully) what it's supposed to do. The chemistry of Versed is both interesting and unusual. Propofol would have done the job but was unavailable because drug makers have stopped selling it to prisons as a protest against capital punishment. What they ( really) should have known is that Versed can't do #1 well enough, as evidenced by the prisoner writhing and screaming for 43 minutes before the other drugs finally killed him (See: Chemistry, Politics, And The Death Penalty). Lethal injection involves 1) Induction of unconsciousness, 2) administration of a drug to stop breathing, and finally 3) potassium chloride to stop the heart. Except their pharmacology wasn't quite up to snuff. Versed may be a wonderful sedative (a drug that treats anxiety) and hypnotic (a drug that induces sleep), but it is NOT a general anesthetic (induces unconsciousness)-something that the idiots in an Oklahoma prison learned at the expense of a convicted murderer, who they were trying to execute with the wrong drugs. It is truly impossible to worry about anything once you get a nice jolt of the stuff, as depicted in Figure 1.įigure 1: Some fool under the influence of Versed getting eye surgery. Just like I didn't when I was given Versed during my recent ocular procedure (which could be described in culinary terms as "filet of eyeball") (1). Once that bad boy hits your blood - life is good and you simply won't care about whatever misfortune you may be facing at the moment. According to my highly refined (and snooty) palate, the prize for the coolest drug goes to propofol - hands down (See: Your Next Colonoscopy May Be More Fun Than Golf).īut one should not dismiss the awesomeness of Versed (generic name midazolam) simple because propofol eats its lunch. It might have even had a shot at being #1, but we chemists (like wine connoisseurs) can be pretty snooty too. Versed may very well be the second coolest drug out there. Chemophobes, naturopaths, and the art history majors at NRDC may leave now. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.Ĭopyright 1996-2018 Cerner Multum, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Drug information contained herein may be time sensitive. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Every effort has been made to ensure that the information provided by Cerner Multum, Inc.
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