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 CCPU (RCE, Biliary, DVT, E-FAST, AAA) Rob is an Emergency Medicine Advanced Trainee based in Melbourne, Australia. He has special interests in medical education, ECG interpretation, and the use of diagnostic and procedural ultrasound in the undifferentiated and unwell patient.

Follow him on twitter: @rob_buttner | ECG Library |

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