| Name: |
FLUMAZENIL (AnexateR) |
| Classification: |
benzodiazepine antagonist
- used in reversal of benzodiazepine induced CNS depression (will not necessarily reverse sedation or respiratory depression)
- used in diagnosis and/or management of benzodiazepine overdose
|
| Dose: |
- Benzodiazepine associated anaesthesia/sedation:
- 0.2 mg IV direct over 15 seconds
- further incremental doses of 0.1 mg IV direct every 60 seconds to a maximum total dose of 1 mg
- Benzodiazepine overdose:
- 0.3 mg IV direct over 30 seconds
- further incremental doses of 0.3 mg IV direct over 30 seconds repeated every 60 seconds to a maximum total dose of 2 mg
- IV Infusion
- 0.1 - 0.4 mg/hr, titrate to individual response
|
| Administration: |
IV Infusion
1 mg/100 mL D5W or NS |
| Adverse Effects: |
Due to abrupt benzodiazepine withdrawal:
- seizures
- cardiac arrhythmias
- nausea, vomiting
- agitation, discomfort, tearfulness, anxiety
- Cardiovascular:
- hypotension or hypertension
- bradycardia, ventricular asystoles
|
| Caution: |
- should be used with caution in epileptic patients
- should be used with caution in mixed overdoses where there has been co-ingestion of agents that decrease the seizure threshold (e.g. tricyclic antidepressents, phenothiazines)
- should be used with caution with a history of cardiac arrhythmias
|
| Monitoring Therapy: |
- neurological status
- respiratory status
- BP
- HR, ECG
NOTE: duration of benzodiazepines will exceed that of flumazenil; observe closely for recurrence of sedation or respiratory depression |
| CCTC Protocol: |
- Must be administered by a physician.
|
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