What is the reversal agent for a benzodiazepine overdose?

2019-05-05 by No Comments

What is the reversal agent for a benzodiazepine overdose?

Flumazenil, a specific benzodiazepine antagonist, is useful in reversing the sedation and respiratory depression that often occur when benzodiazepines are administered to patients undergoing anesthesia or when patients have taken an intentional benzodiazepine overdose.

Why do benzodiazepines cause respiratory depression?

First, they may cause harm via the central nervous system, which is abundant with GABAA receptors, to which benzodiazepines bind. Benzodiazepine administration has been shown to depress central respiratory drive and chemoreceptor responsiveness to hypercapnea [9,10]

Do benzodiazepines cause bradycardia?

Benzodiazepines, including clonazepam, may cause severe bradycardia. Benzodiazepines may have calcium channel-blocking properties, which may explain the observed bradyarrhythmia.

Why are barbiturates not used anymore?

Barbiturate use and abuse has declined dramatically since the 1970s, mainly because a safer group of sedative-hypnotics called benzodiazepines is being prescribed. Benzodiazepine use has largely replaced barbiturates in the medical profession, with the exception of a few specific indications.

Does benzodiazepines cause respiratory depression?

A concern among clinicians is that benzodiazepines and opioids alone or in combination could cause adverse events, including respiratory depression, confusion, falls, and even premature death in patients with respiratory compromise.

Can Benzos affect your breathing?

Benzodiazepines, such as Ativan or Xanax, may actually contribute to respiratory problems, such as depressing breathing ability and pneumonia, in these patients.

How do you reverse the effects of benzodiazepines?

Flumazenil is a selective competitive antagonist of the gamma-aminobutyric acid (GABA) receptor and is the only available specific antidote for benzodiazepine (BZD) toxicity; it will reverse the effects of BZDs but must be used with caution.

Are Benzos bad for your heart?

Since benzos are tranquilizers and sedatives that are in the drug class of central nervous system depressants, they lower heart rate, core body temperature, blood pressure, and respiration. Usually in the case of an overdose, these vital life functions get too low.

What are the side effects of benzodiazepine overdose?

Usually isolated benzodiazepine overdose causes only mild sedation and can be managed with simple supportive care. The addition of other agents or ethanol will change your risk assessment and increase length of stay and mortality. Alprazolam causes greater CNS depression and is more likely to require intubation and ventilation.

When to use flumazenil for benzodiazepine overdose?

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.

Can a benzodiazepine cause a profound coma?

Profound coma is rare except with alprazolam or in mixed ingestions. Large ingestions can rarely cause hypothermia, bradycardia and hypotension. Resolution of CNS depression occurs within 12 hours (unless elderly or co-morbidities), ataxia will persist for longer and your patient may be a falls risk.

Which is the best antidote for benzodiazepine poisoning?

Flumazenil is a competitive benzodiazepine antagonist with a limited role in the management of benzodiazepine poisoning.