Date of Presentation
5-4-2023 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading to seizures refractory to benzodiazepines. There have also been reports of increased intracranial pressure after flumazenil use in patients with head trauma which only complicates management in patients found unresponsive. This case report presents a case of flumazenil being used in an isolated temazepam overdose in an initially hypotensive unresponsive 66-year-old female that led to a rapid resolution of symptoms with successful extubation from a ventilator and eventual discharge from the ICU.
Keywords
Benzodiazepines, Flumazenil, Drug Overdose, Case Reports, Drug-Related Side Effects and Adverse Reactions, Patient Care Management
Disciplines
Critical Care | Diagnosis | Emergency Medicine | Equipment and Supplies | Health and Medical Administration | Medicinal and Pharmaceutical Chemistry | Medicine and Health Sciences | Patient Safety | Substance Abuse and Addiction | Therapeutics
Document Type
Poster
Included in
Critical Care Commons, Diagnosis Commons, Emergency Medicine Commons, Equipment and Supplies Commons, Health and Medical Administration Commons, Medicinal and Pharmaceutical Chemistry Commons, Patient Safety Commons, Substance Abuse and Addiction Commons, Therapeutics Commons
Isolated Temazepam Overdose: A Unique Case of an Unresponsive Female
Cases of acute overdose presenting to the emergency department pose a great challenge given that history can sometimes be limited or at times be inaccurate. While naloxone is routinely given in the field to help reduce opiate’s sedating effects, the routine use of flumazenil has not been routinely adopted in cases of benzodiazepine overdose. This is because, unlike naloxone, there are many medications that act on the GABA receptor, and flumazenil is only specific for binding to the benzodiazepine/GABA receptor. This can lead to an unmasking of other medications that may be co-ingested that also effect the GABA receptor leading to seizures refractory to benzodiazepines. There have also been reports of increased intracranial pressure after flumazenil use in patients with head trauma which only complicates management in patients found unresponsive. This case report presents a case of flumazenil being used in an isolated temazepam overdose in an initially hypotensive unresponsive 66-year-old female that led to a rapid resolution of symptoms with successful extubation from a ventilator and eventual discharge from the ICU.