![]() ![]() Journal of Toxicology-Clinical Toxicology 2004 42(2):209-216. Should a benzodiazepine antagonist be used in unconscious patients presenting to the emergency department? Resuscitation 2007 74(1):27-37. Flumazenil (Romazicon) is a specific antidote for BZD poisoning, but its use in acute BZD overdose is controversial and its risks usually outweigh any possible benefits. Treatment of benzodiazepine overdose with flumazenil. ![]() The flumazenil in benzodiazepine intoxication multicenter study group.QRS prolongation on the ECG to suggest a possible co-ingestion with a sodium channel blocking drug (i.e.Known or suspected benzodiazepine dependance.Known or suspected co-ingestion of a pro-convulsant.This decision needs to be weighed up with the ability for a ward to manage an infusion and with large adult ingestions it can be easier, quicker and potentially safer to intubate and transfer to ICU Sometimes a flumazenil infusion is warranted.Re-sedation is likely to occur at 90 minutes whereupon further doses will be required.Paediatric dose = 0.01 – 0.02 mg/kg, repeat every minute.Adult dose = 0.1 – 0.2 mg IV and repeat every minute until there is reversal (max dose not exceeding 2mg) clonazepam antidote 221 diazepam antidote 248 maternal use 891 midazolam antidote 516, 517 flumethiazide, chloral hydrate antidote 193 fluorescein.Only administer in an area that can manage potential seizures.The main hesitation for its use relates to dependency of benzodiazepines and mixed overdoses which if the benzodiazepine is reversed my precipitate seizures which will be difficult to control. Usually to reverse procedural sedation, accidental paediatric ingestion with compromise, and rarely to help make a diagnosis of benzodiazepine overdose or if a patient’s airway is compromised without quick access to intubation equipment. precipitated by flumazenil in monkeys treated with oral midazolam (30 mg/kg). ![]() Flumazenil is a competitive benzodiazepine antagonist with a limited role in the management of benzodiazepine poisoning. This series will therefore summarise and assess, on an antidote by antidote. ![]()
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