Names: Generic: flumazenil Trade: Romazicon Class: benzodiazepine antagonist and antidote (C) Indications: benzodiazepine overdose or toxicity (flumazenil is to benzodiazepines what naloxone is to opiates) Mechanism of action: antagonizes the sedative actions of benzodiazepines by inhibiting activity at benzodiazepine receptors in the CNS Side effects: hypertension, palpitations, dysrhythmias, seizures, vertigo, nausea, vomiting, blurred vision, flushing from cutaneous vasodilation Contraindications: hypersensitivity, signs or symptoms of tricyclic antidepressant overdose, seizure history and patients taking benzodiazepines to control seizures or conditions such as status epilepticus administering flumazenil to patients with a seizure history or who are taking benzodiazepines to control seizures may send them into status epilepticus Precautions: use caution in patients with renal disease, head injury, panic disorders or who are hyperventilating Interactions: administering flumazenil in cases of cyclic antidepressant or poly-drug overdose may precipitate seizures Routes of administration: slow IVP, IO Onset: 1-2 minutes Duration: dependent on the amount of benzodiazepines in the patient's system flumazenil has a short half- life and repeated doses may be necessary Dosages Adult National 0.2mg over 1 min, followed PRN by 0.3mg over 1 min, then 0.5mg over 1 min given every minute PRN (3mg max total dose)
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