Benzo Reversal agent

Question 0

What is the mechanism of action of Flumazenil?

Answer 0

“Competitively inhibits action of benzo at GABA receptor.

Reversal of benzos and differential diagnosis of coma.”

Question 1

What is the drug classification of Flumazenil?

Answer 1

“Benzo receptor antagonist Imidazobenzodiazepine derivative”

Question 2

What is the onset, Peak, DOA, and Hepatic metabolism and renal excretion of flumazenil?

Answer 2

“Onset = rapid
Peak = 2-10mins
DOA = 30-30mins
Hepatic metabolism and renal excretion”

Question 3

What are the adverse effects of Flumazenil?

Answer 3

“Reversal of resp depression and sedation
Sweating, HA, abnormal vision
Confusion ,euphoria, depression
**no increase in HR or BP, agitation or anxity or neuroendocrine response when used post op (unlike with narcan)”

Question 4

What are the contraindications of Flumazenil?

Answer 4

“Hypersensitivity
Seizures History
Hepatic failure”

Question 5

What is the dosage of Flumazenil?

Answer 5

“0.2mg IV – wait 2 mins peak, then 0.1mg Q 1 min (max 3mg)
5mg to differentiate OD on benzos versus coma

Infusion of 0.1-0.4mg/kg (0.5-1mcg/kg/min) for reversal of long acting benzo like lorazepam)”