Pharm 101: Flumazenil

Class

Benzodiazepine antagonist


Pharmacodynamics
  • Competitive antagonist for benzodiazepine binding site on GABA-A receptor
  • Reverses sedative effects of benzodiazepines
  • Unpredictable reversal of respiratory depression

Pharmacokinetics
  • IV administration
  • Rapid onset
  • Rapid hepatic clearance
    • Short half-life 1 hour

Clinical uses
  • Reversing CNS depressant effects of benzodiazepine overdose
  • Hasten recovering following use of drugs in anaesthetic and diagnostic procedures

Adverse effects
  • Agitation, confusion, dizziness, nausea
  • Severe precipitated abstinence syndrome in those with benzodiazepine dependence
  • Recurrence of sedation due to short half-life
    • Half-life of benzodiazepines if significantly greater
    • Repeated administration often necessary
  • Seizures and cardiac arrhythmias may occur if patient has co-ingested TCAs with benzodiazpines

Further reading

References

Pharm 101 700

Pharmacology 101

Top 200 drugs

MBBS (UWA) CCPU Emergency Medicine Trainee with interests in medical education, ECG interpretation, and the use of point-of-care ultrasound in the undifferentiated patient. Co-author of the LITFL ECG Library | Twitter

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