![]() This approach provides caregivers with means of obtaining a more accurate history of ingestion directly from the patient, as well as preventing some of the more severe complications of a comatose state, such as aspiration pneumonitis, airway obstruction, and respiratory depression. ![]() However, in cases of significant overdose resulting in drug-induced coma, an antidote can be used to reverse the effects of sedatives. Toxicity from benzodiazepines is rarely directly fatal. ![]() Oversedation, confusion, and prolonged intensive care stays are common complications. The sheer availability of these medications and other sedatives makes them frequently used agents in both intentional and unintentional poisoning. We conclude that flumazenil is a safe diagnostic and therapeutic antidote for cases of suspected sedative-hypnotic toxicity.īenzodiazepines are some of the most commonly prescribed sedative/hypnotic and anticonvulsant medications worldwide. No clinically significant adverse events occurred with flumazenil administration in patients who chronically used benzodiazepines or had a history of seizures. Comorbid anxiety disorders were associated with anxiety upon arousal, but no patient required medical intervention. Three patients experienced drooling, 7 experienced transient anxiety, and there were 2 separate episodes of odd behavior upon awakening from coma in a patient with personality disorder. In the prospective year, there were 12 instances of side effects out of 212 patients treated. There were no instances of arrhythmias or seizures. The overall positive response rate was over 80%. The following reports a six-year retrospective review of the practice and a one-year close observational study of bedside use of the antidote. A dose of 0.5 mg is given IV over 30 s, with repeat doses q1-2h as needed to sedated patients with relaxed autonomic indices and peripheral neurologic status. At one toxicology center, flumazenil is routinely employed in the emergency department and acute hospital setting. Although a direct antidote is available, it is rarely used due to fears of withdrawal and seizures. benzodiazepines) affects cognition, behavior, and functional status.
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