A study was undertaken to examine the frequency of use, safety and efficacy of flumazenil in the management of BZD OD in the UK.Ī 2-year retrospective cohort study was performed of all enquiries to the UK National Poisons Information Service involving BZD OD.įlumazenil was administered to 80 patients in 4504 BZD-related enquiries, 68 of whom did not have ventilatory failure or had recognised contraindications to flumazenil. Flumazenil is an effective antidote but there is a risk of seizures, particularly in those who have co-ingested tricyclic antidepressants. ( JAMA.Benzodiazepine (BZD) overdose (OD) continues to cause significant morbidity and mortality in the UK. Flumazenil is best left for reversal of therapeutic conscious sedation and rare select cases of benzodiazepine overdose.

Administration of naloxone hydrochloride should be reserved for patients with signs and symptoms of opioid intoxication. Although rapid reagent test strips can be used to guide this therapy, they are not infallible, and they fail to recognize clinical hypoglycemia that may occur without numerical hypoglycemia.

Analysis favors empirical administration of hypertonic dextrose and thiamine hydrochloride to patients with altered consciousness. Trials were reviewed for overall methodology, inclusion and exclusion criteria, sources of bias, and outcome.Ĭonclusion. Small trials, case series, and case reports were reviewed extensively for adverse effects.ĭata Extraction and Synthesis. Only large trials were used for determinations of diagnostic utility and efficacy. Search terms included poisoning, overdose, toxicity, naloxone, glucose, thiamine, and flumazenil. Older literature was included when pertinent. Data for discussion were obtained from a search of English-language publications referenced on MEDLINE for the years 1966 to 1994. In this review article, the risks and benefits of standard diagnostic and therapeutic interventions are presented to guide clinicians through this critical period of decision making.ĭata Sources.

In the assessment and management of the potentially poisoned patient with altered consciousness, the most consequential and controversial interventions occur during the first 5 minutes of care.

Benzo overdose antidote