title: [Specific therapy of acute benzodiazepine poisoning using flumazenil (Ro 15-1788)].
abstract: In 20 patients with coma (grade 4: n = 7, grade 3: n = 8, grade 2: n = 2, grade 1: n = 3) due to benzodiazepine intoxication, solely or combined with alcohol or other psychoactive drugs, the effect of a specific benzodiazepine antagonist, Flumazenil (Ro 15-1788), was evaluated. In terms of coma depth, 80% of the patients responded to application of 1.96 mg Flumazenil as a mean with immediate awakening or improvement of at least two steps in coma grading. In those 3 patients, who failed to respond to Flumazenil, the history revealed amitriptyline or barbiturates to be responsible for the comatose state. The observed side-effects of Flumazenil included increase (n = 4) or decrease (n = 3) of blood pressure, increase of heart rate (n = 7), cutaneous flush (n = 1) and ventricular extrasystoles (n = 1). Agitation and generalized convulsions, each observed in 1 patient, presumably were due to an acute benzodiazepine-withdrawal rather than an intrinsic side effect of the antagonist. In conclusion, Flumazenil proved to be a potent antagonist of benzodiazepines in patients with severe coma and even may serve as a valuable diagnostic in cases of suspected benzodiazepine intoxication.
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000506:poisoning*; D003128:Coma / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D005442:Flumazenil / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted
chemical_list: D014151:Anti-Anxiety Agents; D005442:Flumazenil
vernacular_title: Spezifische Therapie der akuten Benzodiazepinintoxikation mittels Flumazenil (Ro 15-1788).