The role of flumazenil in the critically ill.
Flumazenil is a specific benzodiazepine antagonist. It competitively inhibits the action of benzodiazepines at gamma aminobutyric acid (GABA) receptors in the central nervous system and thus reverses the sedative effects of benzodiazepines. Usually, it is given intravenously as a bolus dose or as an infusion. It has a short duration of action. Flumazenil is extensively metabolized to compounds that have minimal benzodiazepine antagonistic properties. Reversal of sedation can be useful in many conditions that are often encountered in the critically ill. The adverse effects of its use are usually predictable and, with sufficient clinical monitoring, are usually avoidable. These properties make it a useful and safe drug when used appropriately.
Park
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John Farman Intensive Care Unit, Addenbrooke's NHS Trust Hospital, Cambridge, UK.
Navapurkar
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Ferenci
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D001569:Benzodiazepines / Q000037:antagonists & inhibitors*; D001921:Brain / Q000187:drug effects; D016638:Critical Illness; D005442:Flumazenil / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D018756:GABA Antagonists / Q000627:therapeutic use; D018757:GABA Modulators / Q000008:administration & dosage / Q000009:adverse effects / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000037:antagonists & inhibitors; D007275:Injections, Intravenous; D013131:Spine / Q000187:drug effects
D018756:GABA Antagonists; D018757:GABA Modulators; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D005442:Flumazenil