Presentation
[…] of overdose.[13][42] Obtaining a laboratory test for benzodiazepine blood concentrations can be useful in patients presenting with CNS depression or coma of unknown origin. [en.wikipedia.org]
Entire Body System
- Gastric Lavage
It is recommended only if benzodiazepines have been taken in combination with other drugs that may benefit from decontamination.[45] Gastric lavage (stomach pumping) or whole bowel irrigation are also not recommended.[45] Enhancing elimination of the [en.wikipedia.org]
Respiratoric
- Aspiration
IV access with fluid administration and maintenance of the airway with intubation and artificial ventilation may be required if respiratory depression or pulmonary aspiration occurs.[45] Supportive measures should be put in place prior to administration [en.wikipedia.org]
Gastrointestinal
- Nausea
[…] overdose will usually only exhibit these mild CNS symptoms.[12][13] Paradoxical reactions such as anxiety, delirium, combativeness, hallucinations, and aggression can also occur following benzodiazepine overdose.[14] Gastrointestinal symptoms such as nausea [en.wikipedia.org]
Cardiovascular
- Tachycardia
"Flumazenil causing convulsions and ventricular tachycardia". BMJ. 299 (6703): 860. doi:10.1136/bmj.299.6703.860-b. PMC 1837717. PMID 2510872. ^ Burr W, Sandham P, Judd A (June 1989). "Death after flumazepil". [en.wikipedia.org]
Neurologic
- Convulsions
"Flumazenil causing convulsions and ventricular tachycardia". BMJ. 299 (6703): 860. doi:10.1136/bmj.299.6703.860-b. PMC 1837717. PMID 2510872. ^ Burr W, Sandham P, Judd A (June 1989). "Death after flumazepil". [en.wikipedia.org]
Treatment
“Treatment of Drug-Induced Seizures.” British Journal of Clinical Pharmacology 81 (3):412–19. Hantson, Philippe E. 2016. “Toxin-Induced Seizures.” [ciusss-capitalenationale.gouv.qc.ca]
Supportive care is the mainstay of treatment of benzodiazepine overdose. [en.wikipedia.org]
Epidemiology
[47] When flumazenil is indicated the risks can be reduced or avoided by slow dose titration of flumazenil.[46] Due to risks and its many contraindications, flumazenil should be administered only after discussion with a medical toxicologist.[52][53] Epidemiology [en.wikipedia.org]
Pathophysiology
[…] self-poisonings over 10 years (1992–2001), compared with 30 fatal deliberate self-poisonings involving diazepam.[37] In a New Zealand study (2003) of 200 deaths, Zopiclone, a benzodiazepine receptor agonist, had similar overdose potential as benzodiazepines.[38] Pathophysiology [en.wikipedia.org]
Prevention
A determination of possible deliberate overdose should be considered with appropriate scrutiny, and precautions taken to prevent any attempt by the patient to commit further bodily harm.[11][46] Hypotension is corrected with fluid replacement, although [en.wikipedia.org]