Diagnostic tests: Urine qualitative tests for benzodiazepines, serum electrolyte levels, and arterial blood gas analysis. Signs and symptoms of poisoning: Psychomotor retardation, slurred speech, unsteady gait, dizziness, ataxia, dyskinesia, diplopia, somnolence, coma, hyporeflexia, pinpoint pupils, hypotension, hypothermia.Ģ. Their mechanism of action and adverse effects are similar to those of benzodiazepines and overdose treatment is the same.ġ. Zaleplon (not currently sold in Canada), zopiclone, and zolpidem are the most commonly prescribed hypnotic drugs. One of the undesirable effects of benzodiazepines-amnesia-is used for criminal purposes (mainly flunitrazepam the so-called date rape drugs). Short-acting benzodiazepines (eg, midazolam, alprazolam) have a high potential for dependency. Moderate poisoning occurs after the administration of >10 times the therapeutic dose. The therapeutic index of benzodiazepines is high. The half-life of diazepam is between 40 and 70 hours. They are rapidly absorbed from the gastrointestinal tract, metabolized in the liver, and undergo minimal renal elimination in an unchanged form. PubMed PMID: 15822758.īenzodiazepines are central nervous system ( CNS) depressants. Position paper: Single-dose activated charcoal. PubMed PMID: 23418938.Ĭhyka PA, Seger D, Krenzelok EP, Vale JA American Academy of Clinical Toxicology European Association of Poisons Centres and Clinical Toxicologists. Position paper update: gastric lavage for gastrointestinal decontamination. PubMed PMID: 26096314.īenson BE, Hoppu K, Troutman WG, et al American Academy of Clinical Toxicology European Association of Poisons Centres and Clinical Toxicologists. Adverse Events Associated with Flumazenil Treatment for the Management of Suspected Benzodiazepine Intoxication-A Systematic Review with Meta-Analyses of Randomised Trials. Penninga EI, Graudal N, Ladekarl MB, Jürgens G. CNS – dizziness, headache, abnormal or blurred vision, confusion, and convulsions.An H, Godwin J.Cardiovascular – cutaneous vasodialation, sweating, and flushing, dysrhythmias, bradycardia, tachycardia, hypertension.Respiratory – return of respiratory depression which has exceeded the therapeutic effects of flumazenil.Overdose: Excessive doses result in anxiety, agitation, increased muscle tone, and possible convulsions.To avoid pain and inflammation at the site of injection, administration of flumazenil via a large vein is recommended.Patients who have responded to flumazenil should be carefully monitored (up to 120 minutes) for resedation.Flumazenil– induced seizures have been reported in patients with chronic physical dependence to benzodiazepines or patients recently undergoing multiple procedures requiring multiple large doses of benzodiazepines.Individualized dosage is required, manufacturer does not recommend the administration of flumazenil to patients under the age of 18.If no response to treatment is noted, call anesthesia for assistance.ģ0-60 ug/minute (0.5-1 ug/kg/min). If patient does not reach desired level of consciousness after 45 seconds…Ģ) Phase Two: Repeat dose at one minute intervals until a cumulative dose of 1 mg has been administered (includes initial dose in phase one). Specific benzodiazepine antagonist, used for complete or partial reversal of the sedative effects of benzodiazepines management of benzodiazepine overdoseġ) Phase One: Initially 0.2 mg IV over 15 seconds to one minute. Reversal for Benzodiazepines: Flumazenil (Romazicon)Ħ-10 minutes (but 80% of the maximum response is seen within 3 minutes.)Ĭall anesthesia if there is no desired clinical response with the administration of the initial 1 mg.
0 kommentar(er)
