Should not be used in drug overdose cases where seizures (from any cause) are likely (e.g., cyclic depressant overdosage). No known benefit other than reversal of benzodiazepine-induced sedation in seriously ill patients with multiple-drug overdosage. Management of benzodiazepine overdosage used as an adjunct to, not a replacement for, appropriate supportive and symptomatic measures (e.g., ventilatory and circulatory support). Not as effective in completely and consistently reversing benzodiazepine-induced amnesia. Used for complete or partial reversal of sedating and psychomotor effects of benzodiazepines when these drugs are used for diagnostic or therapeutic procedures. Used for complete or partial reversal of sedating and psychomotor effects of benzodiazepines (e.g., midazolam) used for induction or maintenance of general anesthesia.ĭoes not completely restore memory and is not as effective in the reversal of sedation in patients who received multiple anesthetic agents in addition to benzodiazepines. Uses for Flumazenil Reversal of General Anesthesia Written by ASHP.īenzodiazepine antagonist. An interprofessional team approach would help achieve maximum efficacy and minimize potential risks associated with flumazenil therapy.Drug class: Central Nervous System Agents, Miscellaneous 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.
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