Benzodiazepine toxicity: Difference between revisions
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==Treatment== | ==Treatment== | ||
#GI decontamination | #GI decontamination | ||
##Activated | ##[[Activated Charcoal]] x1 | ||
#Mechanical ventilation if necessary | #Mechanical ventilation if necessary | ||
#Flumazenil | #Flumazenil | ||
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###Suspected or known physical dependence on benzodiazepines | ###Suspected or known physical dependence on benzodiazepines | ||
###Suspected TCA overdose | ###Suspected TCA overdose | ||
### | ###Co-ingestion of seizure-inducing agents | ||
###Known seizure disorder | ###Known [[seizure]] disorder | ||
###Suspected increased intracranial pressure | ###Suspected increased intracranial pressure | ||
##Dosing | ##Dosing | ||
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==Disposition== | ==Disposition== | ||
*Consider d/c after 6hr obs | *Consider d/c after 6hr obs | ||
==See Also== | |||
*[[Toxicology (Main)]] | |||
==Source== | ==Source== | ||
Revision as of 07:51, 7 February 2014
Background
- Isolated benzo overdose has low morbidity/mortality
- Coingestion or parenteral administration accounts for vast majority of deaths
Clinical Features
- Somnolence, slurred speech, ataxia (similar to ETOH intoxication)
- Paradoxical reaction (more common in hyperactive children, psychiatric pts)
- Hypotension
- Respiratory depression
Treatment
- GI decontamination
- Mechanical ventilation if necessary
- Flumazenil
- Controversial
- May prevent need for mechanical ventilation; may precipitate benzo-withdrawal seizure
- Indication:
- Consider (though controversial) for coma reversal
- Contraindications:
- Suspected or known physical dependence on benzodiazepines
- Suspected TCA overdose
- Co-ingestion of seizure-inducing agents
- Known seizure disorder
- Suspected increased intracranial pressure
- Dosing
- 0.2mg IV; may repeat q1min (max dose 3mg)
- Flumazenil-Induced Seizure
- Treat with phenobarbital or propofol; benzos will not work
- Controversial
Disposition
- Consider d/c after 6hr obs
See Also
Source
- Tintinalli