title: A poison center's ten-year experience with flumazenil administration to acutely poisoned adults.
abstract: BACKGROUND
  The frequency of seizures among acutely poisoned adults who are administered flumazenil has not been well established.
  
  
  OBJECTIVE
  The objectives of the study were: to determine the frequency of seizures among acutely poisoned adults administered flumazenil; to identify factors associated with seizures; and to determine the mental status of subjects before and after administration of flumazenil.
  
  
  METHODS
  This study was a historical case series of acutely poisoned adults reported to a poison control system from 1999 to 2008. Included cases were those involving administration of flumazenil to subjects who were ≥ 18 years of age. Both genders were included. Variables collected included: presence of seizure or death, exposure to a pro-convulsant drug, and mental status before and after flumazenil administration.
  
  
  RESULTS
  Over the 10-year period studied, 904 cases were identified that met inclusion criteria. Thirteen subjects (1.4%) developed seizures after flumazenil was administered. One death occurred. There were 293 subjects exposed to a pro-convulsant drug, and 8 of these had seizures after flumazenil administration. Development of seizures after flumazenil administration was significantly associated with exposure to a pro-convulsant drug (odds ratio 3.41; 95% confidence interval 1.13-10.72). Mental status before and after flumazenil administration was available for 546 subjects (60.3%). Of these, 291 (53.3%) became awake after administration of flumazenil.
  
  
  CONCLUSIONS
  Flumazenil administration to acutely poisoned adults resulted in a low frequency of seizures and death. Development of seizures was associated with exposure to a pro-convulsant drug. More than half of the subjects for whom mental status was recorded became awake after receiving flumazenil.
authors: Division of Medical Toxicology, University of California San Diego, San Diego, California 92103, USA.
authors: Allyson A
authors: AA
authors: Kreshak
authors: F Lee
authors: FL
authors: Cantrell
authors: Richard F
authors: RF
authors: Clark
authors: Christian A
authors: CA
authors: Tomaszewski
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000931:Antidotes / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000506:poisoning*; D002140:California; D016001:Confidence Intervals; D003243:Consciousness; D003292:Convulsants / Q000506:poisoning*; D005260:Female; D005442:Flumazenil / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012640:Seizures / Q000139:chemically induced*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000931:Antidotes; D003292:Convulsants; D006993:Hypnotics and Sedatives; D001569:Benzodiazepines; D005442:Flumazenil