![]() ![]() 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).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. An interprofessional team approach would help achieve maximum efficacy and minimize potential risks associated with flumazenil therapy.Flumazenil is a competitive benzodiazepine antagonist with a limited role in the management of benzodiazepine poisoning. As depicted above, clinicians(MDs, DOs, NPs, PAs) should collaborate to improve patient outcomes. In addition, medical toxicologist consultation is often required for multiple-drug ingestions. Critical care physician consultation is required in severe poisoning with respiratory depression. Hospital pharmacists should ensure proper dosing of flumazenil. Emergency department physicians should rapidly stabilize the patient. Normally flumazenil overdose is handled by emergency department physicians. Overall, the use of flumazenil to manage benzodiazepine overdose is diminishing as the drug may cause more harm than good. A few patients may develop rhabdomyolysis and aspiration pneumonia. In most isolated cases of benzodiazepine overdose, supportive management may prove useful. The problem arises when the individual has co-ingested alcohol or other illicit drugs. In general, patients who overdose on benzodiazepines alone rarely have significant mortality. The nurse and the pharmacist should educate the patient on the use of benzodiazepines, their potential to cause addiction, and physical dependence. ![]() The ideal circumstance for flumazenil is when a naive benzodiazepine individual has overdosed. Additionally, all healthcare workers need to know that this drug should not be used in patients with a history of seizures, head injury, or those who have ingested a tricyclic antidepressant. The drug may precipitate seizures and withdrawal in patients who have been using benzodiazepines for a medical disorder. Not everyone with benzodiazepine overdose will respond to it. The problem with flumazenil is that its effects are not consistent or predictable. Despite the initial hype about the drug, many experts believe that its risks may outweigh its benefits. This competitive antagonist of benzodiazepines can rapidly reverse benzodiazepine overdose. Today, with the epidemic of drug overdoses, nurses, pharmacists, and physicians need to be aware of flumazenil. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |