Other treatments including aminophylline and MARS can be used when patients do not respond to flumazenil, but the patient is at increased risk of complications due to prolonged coma. If further expert help is required: call Poison Control, available 24/7 at 1-80 in the US. Thus, these patients should be closely monitored for these adverse effects. It is ineffective in the treatment of heavy metal toxicity (e.g., mercury, lead), cyanide, lithium, acids, bases, and toxic alcohols such as methanol. ![]() Flumazenil administration should be withheld whenever complications start to develop. Unsteady gait Benzodiazepine doses for children and older adults should be small with gradual increases to avoid ataxia (unsteady gait) and excessive sedation. To prevent flumazenil complications, it should be given in small (0.1-mg) slow (every one minute) doses to a maximum of 3 mg. The patients should be selected with caution, and flumazenil should not be routinely administered to all patients referred with loss of consciousness. ![]() The physicians generally prefer to treat benzodiazepine poisoning conservatively mainly due to fear of flumazenil side effects.įlumazenil is a great antidote in special circumstances and populations including elderly patients, pregnant patients, those with background disorders, and crowded emergency departments or when the patient refers with grave loss of consciousness and needs a vast work-up. Pure benzodiazepine poisoning or co-ingestion is extremely common worldwide.
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