Reversal of an Antihistamine-Induced Coma With Flumazenil

Lassaletta, Álvaro; Martino, Ricardo; Gónzalez-Santiago, Pilar; Torrijos, Carmen; Cebrero, Margarita; García-Frías, Enrique

doi:10.1097/01.pec.0000125662.28066.91

Cited by 14 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Flumazenil was successfully used in the cases reported by Rubio et al (1993) [16], which support its therapeutic use in cases of cannabis-induced coma. This is consistent with other reports of reversal of the acute brain effects of the drug in different conditions, such as hepatic encephalopathy and intoxication by alcohol, carbamazepine, chloral hydrate, isoflurane, and antihistamines [38-40]. …”

Section: Resultssupporting

confidence: 93%

Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

et al. 2012

View full text Add to dashboard Cite

BackgroundCannabis intoxication is related to a number of physical and mental health risks with ensuing social costs. However, little attention has been given to the investigation of possible pharmacological interactions in this condition.ObjectiveTo review the available scientific literature concerning pharmacological interventions for the treatment of the acute effects of cannabis.MethodsA search was performed on the Pubmed, Lilacs, and Scielo online databases by combining the terms cannabis, intoxication, psychosis, anxiety, and treatment. The articles selected from this search had their reference lists checked for additional publications related to the topic of the review.ResultsThe reviewed articles consisted of case reports and controlled clinical trials and are presented according to interventions targeting the physiological, psychiatric, and cognitive symptoms provoked by cannabis. The pharmacological interventions reported in these studies include: beta-blockers, antiarrhythmic agents, antagonists of CB-1 and GABA-benzodiazepine receptors, antipsychotics, and cannabidiol.ConclusionAlthough scarce, the evidence on pharmacological interventions for the management of cannabis intoxication suggests that propanolol and rimonabant are the most effective compounds currently available to treat the physiological and subjective effects of the drug. Further studies are necessary to establish the real effectiveness of these two medications, as well as the effectiveness of other candidate compounds to counteract the effects of cannabis intoxication, such as cannabidiol and flumazenil.

show abstract

Section: Resultssupporting

confidence: 93%

Pharmacological interventions in the treatment of the acute effects of cannabis: a systematic review of literature

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Não possui dose diária definida (DDD) e seu uso é indicado, principalmente, na reversão da ação sedativa após a anestesia, bem como no tratamento da superdosagem aguda de benzodiazepínicos 14,15 . Outros usos, ainda que insuficientemente estabelecidos, foram descritos na literatura para melhora do estado mental de pacientes com hepatopatias graves (encefalopatia hepática) 16,17 , intoxicação alcoólica 18,19 e intoxicação por plantas do gênero Cannabis 20 .…”

Section: Revisão De Literaturaunclassified

Fatores Relacionados à Utilização de Flumazenil em Pacientes Hospitalizados

Lima-Dellamora¹

2015

Rev. enferm. UERJ

View full text Add to dashboard Cite

RESUMO: Interações medicamentosas (IM) exacerbam o risco de eventos adversos graves relacionados ao uso de benzodiazepínicos. Este estudo objetivou conhecer aspectos relacionados à utilização de flumazenil em pacientes hospitalizados. Através do método observacional, foram analisados prescrições e prontuários de 31 pacientes internados entre junho/2008 e junho/2010 quanto à indicação do flumazenil, aos fatores que podem ter contribuído para intoxicação por benzodiazepínicos e à frequência de IM potenciais (IMP). A frequência de indicação para reversão de sedação excessiva foi aproximadamente 1,3 prescrições por 1.000 pacientes. Foram identificadas IMP em 84% dessas prescrições. Para sete casos, não houve prescrição prévia de benzodiazepínicos. O exame permitiu a identificação dos eventos com necessidade do manejo da sedação excessiva relacionados à ocorrência de IMP entre benzodiazepínicos e outros medicamentos para um elevado percentual de pacientes. Observou-se que idade elevada, quadro clínico com muitas comorbidades e administração de medicamentos com interações bem definidas estiveram associados à hipersedação. Palavras-Chave: Flumazenil; interações de medicamentos; eventos adversos; benzodiazepínicos. ABSTRACT: Drug interactions (DIs) heighten the risk of severe adverse events connected with use of benzodiazepines. This observational study aimed to ascertain aspects of use of flumazenil in hospital inpatients. The prescriptions and medical records of 31 patients admitted between June 2008 and June 2010 were examined for indication of flumazenil, factors that could have contributed to benzodiazepine intoxication, and potential drug interaction (PDI) frequency. In 1.3 prescriptions per 1,000 patients the indication was for reversal of excessive sedation. PDIs were observed in 84% of these prescriptions. In 7 cases there was no prior prescription of benzodiazepines. The examination identified events requiring management of excessive sedation associated with occurrence of PDI between benzodiazepines and other drugs in a high percentage of patients. It was observed that more advanced age, clinical condition with many comorbidities, and administration of drugs with well-defined interactions were observed to associate with over-sedation.

show abstract

“…20 The knowledgeable RN would be wary of administering additional central nervous system depressants in conjunction with these types of medications. Antihistamine abuse, whether intentional or nonintentional, has the potential to cause respiratory depression and mental status changes.…”

Section: Practical Pearlsmentioning

confidence: 99%