Flumazenil " Anexate"

dr.joan

Flumazenil " Anexate" :
Trade names: Anexate
Drug class: Benzodiazepine antagonist; reverses sedative effects of benzodiazepines used in conscious sedation and general anesthesia; treatment of benzodiazepine overdose
Pregnancy: (Category C)

Therapeutic actions

Competitively inhibits the activity at the benzodiazepine recognition site on the GABA/benzodiazepine receptor complex. Flumazenil does not antagonize the CNS effect of drugs affecting GABA-ergic neurons by means other than the benzodiazepine receptor (ethanol, barbiturates, general anesthetics) and does not reverse the effects of opioids
Dose:
§ By intravenous injection, 0.8–2 mg repeated at intervals of 2–3 minutes to a max. of 10 mg if respiratory function does not improve (then question diagnosis); CHILD 10 micrograms/kg; subsequent dose of 100 micrograms/kg if no response
§ By subcutaneous or intramuscular injection, as intravenous injection but only if intravenous route not feasible (onset of action slower)
§ By continuous intravenous infusion using an infusion pump, 10 mg diluted in 50 mL intravenous infusion solution at a rate adjusted according to the response

Adverse Reactions

§ >10%
§ Gastrointestinal: Vomiting, nausea
§ 1% to 10%:
§ Cardiovascular: Palpitations
§ Central nervous system: Headache, anxiety, nervousness, insomnia, abnormal crying, euphoria, depression, agitation, dizziness, emotional lability, ataxia, depersonalization, tears increased, dysphoria, paranoia, fatigue, vertigo
§ Endocrine & metabolic: Hot flashes
§ Gastrointestinal: Xerostomia
§ Local: Pain at injection site
§ Neuromuscular & skeletal: Tremor, weakness, paresthesia
§ Ocular: Abnormal vision, blurred vision
§ Respiratory: Dyspnea, hyperventilation
§ Miscellaneous: Diaphoresis
§ <1%: Abnormal hearing, altered blood pressure (increases and decreases), confusion, sensation of coldness, bradycardia, chest pain, generalized convulsions, hiccups, hypertension, junctional tachycardia, shivering, somnolence, tachycardia, thick tongue, ventricular tachycardia, withdrawal syndrome
§ Postmarketing and/or case reports: Fear, panic attacks
Overdosage/Toxicology

Excessively high doses may cause anxiety, agitation, increased muscle tone, hyperesthesia and seizures.

Nursing Implications

§ Parenteral: For I.V. use only;
§ administer via freely running I.V. infusion into larger vein to decrease chance of pain, phlebitis

Patient Education

§ Flumazenil does not consistently reverse amnesia. Do not engage in activities requiring alertness for 18-24 hours after discharge.
§ Avoid alcohol or OTC medications for 24 hours after receiving this medication, unless approved by prescriber.
§ Resedation may occur in patients on long-acting benzodiazepines (such as diazepam).
§ Pregnancy/breast-feeding precautions: Should Inform physician if you she is or intend to become pregnant and Consult him if she is a breast-feeding.