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Remimazolam is an ultra short-acting intravenous benzodiazepine used for the induction and maintenance of procedural sedation in adults during short diagnostic or surgical procedures. It acts as a positive allosteric modulator at the benzodiazepine site of gamma-aminobutyric acid type A (GABA(A)) receptors, enhancing the inhibitory effects of GABA in the central nervous system. This results in rapid onset and offset of sedation with predictable pharmacokinetics and minimal tissue accumulation. Remimazolam was developed by PAION AG as an alternative to midazolam, offering faster recovery times and a more favorable safety profile due to its rapid hydrolysis by non-specific tissue esterases into inactive metabolites. Its sedative effects can be reversed with flumazenil[1][4][5][7].
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