![]() Flumazenil is contraindicated in intentional overdose (it can precipitate seizures in withdrawal or mixed overdoses).Enhancement of benzodiazepine elimination is not effective and is not recommended.Gastrointestinal decontamination with activated charcoal is contraindicated because of the increased risk of aspiration.If respiratory depression, a concomitant opioid overdose may be present and it is reasonable to administer appropriate doses of parenteral naloxone.Standard procedures and supportive care.Measurement of serum benzodiazepine concentration correlates poorly with clinical findings and will not aid management. In intentional overdoses, consider co-ingestion risk, therefore Other – withdrawal syndrome, paradoxical reactions (agitation, aggression, hallucinations and combativeness)Īlways check for Medicalert bracelet in any unconscious patient, or any other signs of underlying medical condition (fingerprick marks etc.) Investigations.Neurologic – confusion, dysarthria, nystagmus, lethargy, ataxia, areflexia, hypotonia, seizure.Calculate the maximum possible dose per kg of each drug.If possible, determine the exact name and tablet strength.Always assume maximum number of missing/unaccounted tablets have been ingested.Risk assessment Red flag features in Red History Diazepam is excreted mainly (about 70%) unchanged in the urine.Īll children with deliberate self-poisoning or significant accidental ingestion, especially younger children and toddlers.Īny child whose developmental age is inconsistent with accidental poisoning as non-accidental poisoning should be considered.An exception to this is Oxazepam, temazepam, and lorazepam which are directly conjugated.Drugs that interact with CYP enzymes may prolong the half-lives of most Benzodiazepines They are rapidly absorbed in the gastrointestinal tract, with peak plasma concentrations occurring 30 to 90 minutes after ingestion.Short-acting (half-life 24 h) eg Diazepam, these generally have pharmacologically active metabolites, accumulate in tissues after multiple doses, and demonstrate impaired clearance in children with liver disease.Benzodiazepines can be short, intermediate or long acting:.Sedation can be prolonged and last up to 36 hours.All intentional overdoses require a Mental Health Assessment.įor 24 hour advice, contact Victorian Poisons Information Centre 13 11 26 Background. ![]()
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