Benzodiazepines Poisoning

Introduction

Poisons are chemical or physical agents that produce adverse responses in biological systems.
Poisoning on the other hand is the ingestion by, or exposure of a patient to excessive doses of a medicine or other substances that may cause harm
Benzodiazepines Poisoning most commonly involves diazepam and bromazepam.
These drugs potentiate the inhibitory
effect of GABA on CNS neurons

Clinical features of Benzodiazepine poisoning

  • CNS depression may occur within 30 minutes of acute overdose
  • Respiratory depression
  • Coma, especially when benzodiazepines are combined with other CNS depressants
  • Paradoxical excitement may occur early in the course of poisoning

Treatment for Benzodiazepine poisoning

Treatment objectives

The treatment objectives of Benzodiazepine poisoning include the following:

  1. To prevent or reduce damage to organs
  2. To restore normal metabolic functions
  3. As for paracetamol poisoning

Non-drug treatment

  • Respiratory support

Drug treatment

  • Activated charcoal: method of choice for gastrointestinal decontamination
  • Flumazenil, a competitive benzodiazepine receptor antagonist, can reverse CNS and respiratory depression
    • Given as 200 micrograms Flumazenil over 15 seconds; then 100 microgram at 1 minute intervals if need. Usual dose range: 300-600 microgram IV over 3-6 minutes; up to 1mg maximum or 2mg if in intensive care unit)

Notable adverse drug reactions.

  • Flumazenil may trigger seizures
  • Activated charcoal colours stools
    black