Flumazenil: uses, characteristics and side effects
This drug is often used in clinical settings to affect the state of consciousness.
Numerous media have reported on the increasing use and the increasing use and abuse of psychotropic drugs in our society.. Benzodiazepines are among the most commonly used drugs to deal with anxiety disorders, playing a supportive role in many psychological treatments.
However, all that glitters is not gold: it has been documented that benzodiazepines can cause physical and psychological dependence in the person (leading to overdose), excessive drowsiness and even depressive symptoms, interfering with the daily life of the user.
Flumazenil, which is the subject of this articleflumazenil, is the drug in charge of combating the drowsiness produced by benzodiazepines in very specific situations.
What is Flumazenil?
Flumazenil (trade names: Anexate, Lanexat, Mazicon, Romazicon) is a drug that works as a GABA antagonist. a drug that functions as a GABA antagonist.. It blocks, by competitive inhibition, the effects produced by benzodiazepines in our Central Nervous System. At the moment it is the only benzodiazepine receptor antagonist available in the pharmaceutical market.
As we shall see, two basic properties are attributed to this drug. On the one hand, it reverses the sedation produced by benzodiazepines.. On the other hand, it helps to reduce psychomotor slowness.
Uses of Flumazenil
Flumazenil is used in adults to correct the sedative effects of benzodiazepines. It can be used in two main situations: anesthesia and palliative care..
In anesthesia, it is used for to end the hypnosedative effects of general anesthesia, maintained or induced in or induced general anesthesia in hospitalized patients. It is also used for the reduction and correction of sedation due to the use of benzodiazepines in diagnostic or therapeutic procedures in outpatient or inpatient settings.
In intensive care, it is used to reestablish the patient's spontaneous breathingIn intensive care, the aim is to restore the patient's spontaneous breathing, correcting the central effects of benzodiazepines. In addition, it is also used for the diagnosis and treatment of overdose or intoxication resulting from benzodiazepine abuse.
In addition to these uses, there is evidence that flumazenil may be effective in the treatment of prolonged benzodiazepine withdrawal, with quite promising results.There is also evidence that flumazenil may be effective in reducing benzodiazepine tolerance, with promising results, although further studies are needed.
It has also been used to treat hepatic encephalopathy, although in this case the results have been contradictory and not so promising.
Its use is not suitable for the pediatric population, only for children over 1 year of age.
Form of administration and dosage
This medicine can only be administered intravenously, so it can only be applied by a professional only a health professional can administer it.. Flumazenil can be administered as an injection or infusion and can be used in parallel with other resuscitation techniques.
In terms of dosage, we will only focus on the adult population. In cases where the person has been anesthetized, the recommended dose is 0.2 milligrams, administered intravenously, for approximately 15 seconds. In cases where the required degree of consciousness has not been obtained, an additional dose of 0.1 mg can be injected. In general terms, the usual dose required in these cases fluctuates between 0.3-0.6mg..
The dose is different in intensive care. Start with a dose of 0.3mg intravenously; If the required degree of consciousness is not obtained within 60 seconds.If the required degree of consciousness is not obtained within 60 seconds, a dose of 0.1mg can be applied, up to a maximum dose of 2.0mg.
It could be that the person does not recover the desired degree of consciousness and that his breathing is not stable after the administration of the doses. In these cases, it should be taken into consideration that the intoxication may not be caused by the consumption of benzodiazepines.
Side effects
As is the case with the vast majority of drugs on the market, a series of adverse reactions may occur, which are detailed below. However, many of the adverse reactions usually disappear rapidly or progressively without the need for special intervention.
Very frequent
- Insomnia.
- Drowsiness.
- Dizziness and headaches.
- Dry mouth and tremors..
- Hyperventilation.
- Convulsions.
Frequent
Hypotension. Nausea and vomiting. Sweating. Fatigue. Pain at the injection site.
Infrequent
- Anxiety and fear.
- Panic attacks in patients with a history of panic attacks.
- Abnormal hearing.
- Palpitations.
- Tachycardia or bradycardia.
- Cough and nasal congestion.
Warnings and precautions
Before using flumazenil, a number of precautions should be taken into account.
Flumazenil has a shorter effect than benzodiazepines, so it is recommended that the patient be monitored in the intensive care unit until the effect of flumazenil is assumed to have worn off.
The use of flumazenil is not always the best option. For example, in patients with cardiac problemsIn these cases, it is not always a good alternative for the patient to wake up quickly from anesthesia. In these cases it may be preferable to maintain a certain degree of sedation.
After major surgery, it is important to keep in mind that the patient will be in Pain during the postoperative period. It may therefore be preferable to keep the patient lightly sedated.
Special consideration should be given to the dosage of flumazenil in people with preoperative anxiety or those with a history of anxiety disorders.
The use of flumazenil is not recommended in patients with epilepsy who have previously received treatment with benzodiazepines for a prolonged period.
In people treated for prolonged periods of time with high doses of benzodiazepines, the advantages of using flumazenil should be carefully weighed against the risk of triggering withdrawal symptoms.
Flumazenil should be used with caution in patients with alcoholism. patients suffering from alcoholismdue to increased tolerance and dependence on benzodiazepines in this population.
Contraindications
When should flumazenil not be administered? Its use is not recommended in patients with known hypersensitivity to flumazenil or benzodiazepines. According to experts, it should also not be used in patients who have been given a benzodiazepine to control a life-threatening condition (e.g., endocranial pressure).
(Updated at Apr 15 / 2024)