" Cases in which to consider flumazenil are pediatric patients and reversal of procedural sedation if needed. There is a significant risk of seizure when flumazenil is administered under those circumstances. So, it's no surprise there weren't any seizures or deaths.Ī recent systematic review and meta-analysis of randomized trials summed it up perfectly: " Flumazenil should not be used routinely, and the harms and benefits should be considered carefully in every patient. Using The Benzodiazepine Antidote Can Be Dangerous Flumazenil should never be used when the person has additional drugs besides benzodiazepines or if the person is in withdrawal from benzodiazepines. In the pediatric study, we wouldn't expect children to experience withdrawal since they aren't on chronic benzodiazepine therapy. But, retrospective poison center studies from voluntary reporting cannot be used to prove a drug's safety. On the surface, it may appear that flumazenil is safe to give. Patient education should include explaining the consequences. The main indication is to discourage drinking alcohol by causing unpleasant physical reactions. Disulfiram (Antabuse) indication and patient education Disulfiram (Antabuse) is a medication used to treat alcohol use disorder. A third study found 80 patients with 1 seizure and 0 deaths. The antidote for benzodiazepine overdose is flumazenil. ![]() A second study specific to pediatric patients reported 83 patients with no seizures and no deaths. ![]() In the first study there were 904 adult patients with 13 reported seizures and 1 death. Three relatively recent poison center studies have attempted to demonstrate the safety of flumazenil in this setting. ![]() 2-4 Flumazenil does not antagonize the effects of any sedative drugs (e.g., ethanol, barbiturates) that do not act at the benzodiazepine receptor. Flumazenil is generally avoided in most adult patients with suspected benzodiazepine overdose due to resedation, seizures/withdrawal, inconsistent reversal of respiratory depression, and the potential for proconvulsant coingestants. In both animals and humans, flumazenil blocks the anxiolytic, muscle relaxant, sedative, ataxic, anticonvulsant, amnestic and anesthetic effects of the benzodiazepines.
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