Continuous-infusion flumazenil in the management of chlordiazepoxide toxicity.
Flumazenil is indicated for reversal of sedation from benzodiazepines administered during therapeutic or diagnostic procedures and during induction or maintenance of general anesthesia, as well as for benzodiazepine overdose. Bolus doses of flumazenil are usually adequate to achieve reversal; however, when medical conditions may lead to a prolonged half-life of the benzodiazepine involved, continuous infusion may be warranted. A 67-year-old man with chlordiazepoxide toxicity required a 9-day infusion of flumazenil to prevent resedation and respiratory insufficiency; he initially was admitted to the hospital for alcohol detoxification. Concomitant medical conditions and the metabolism characteristics of each benzodiazepine must dictate the agent of choice. When measures are required to ensure adequate recovery of a patient's respiratory function and mental awareness, such as in patients with benzodiazepine toxicity, consideration of continuous-infusion flumazenil is warranted.
Maxa
Jan L
JL
Department of Pharmacy, Baylor University Medical Center, Dallas, Texas, USA. janma@bhcs.edu
Ogu
Chris C
CC
Adeeko
M Alade
MA
Swaner
Thomas G
TG
D000368:Aged; D002707:Chlordiazepoxide / Q000009:adverse effects* / Q000097:blood; D019468:Disease Management; D005442:Flumazenil / Q000008:administration & dosage*; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D012131:Respiratory Insufficiency / Q000097:blood / Q000139:chemically induced* / Q000188:drug therapy*
D005442:Flumazenil; D002707:Chlordiazepoxide