Questions and Answers
What is the brand name of FLUMAZENIL?
What classification does FLUMAZENIL belong to?
Benzodiazepine antagonist
What is the mechanism of action of FLUMAZENIL?
Competes with benzodiazepines at the binding site
What is a primary indication for FLUMAZENIL?
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What are some contraindications for FLUMAZENIL?
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Which of the following are side effects of FLUMAZENIL? (Select all that apply)
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What precautions should be taken when administering FLUMAZENIL?
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What routes of administration are available for FLUMAZENIL?
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What is the onset and duration of action for FLUMAZENIL?
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What is the adult dosage for FLUMAZENIL?
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What should be monitored during the assessment of a patient receiving FLUMAZENIL?
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What is the recommended cautious use of FLUMAZENIL?
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What are the pharmacokinetics of FLUMAZENIL?
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What teaching should be given to patients after FLUMAZENIL administration?
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Study Notes
Flumazenil Overview
- Brand name: Romazicon
- Classification: Benzodiazepine antagonist
Mechanism of Action
- Competes with benzodiazepines at binding sites in the CNS.
- Antagonizes effects such as sedation, impairment of recall, and psychomotor impairment.
- Does not reverse opioid effects.
Indications
- Primarily indicated for benzodiazepine overdose.
Contraindications
- Hypersensitivity to flumazenil or any benzodiazepines.
- Patients requiring benzodiazepines for life-threatening conditions.
- Patients exhibiting cyclic antidepressant overdose signs.
- Seizure-prone individuals during labor and delivery.
- Safety in children not established.
Side Effects
- CNS effects: Emotional lability, headache, dizziness, agitation, resedation, seizures, blurred vision.
- GI effects: Nausea, vomiting, hiccups.
- Other effects: Shivering, injection site pain, hypoventilation.
Precautions
- Monitor closely for seizures.
Drug Interactions
- May antagonize effects of sleep medications like zaleplon and zolpidem.
- Risk of convulsions or arrhythmias when mixed with tricyclic antidepressants.
Administration
- Route: Intravenous (IV) only.
Onset and Duration
- Onset: 1-2 minutes after administration.
- Duration: Effects may last 1-2 hours.
Dosages
- Adult dosage: 200 mcg every 1-2 minutes as needed, maximum of 3 mg/hour.
- Pediatric use is not recommended.
Cautious Use
- Special care required in patients with impaired hepatic function, older adults, pregnant individuals (category C), lactating mothers, those in intensive care, head injury cases, and patients with drug or alcohol dependence.
Pharmacokinetics
- Onset: 1-5 minutes.
- Peak effect: 6-10 minutes.
- Duration: 2-4 hours.
- Metabolism: Inactive metabolites formed in the liver.
- Elimination: 90-95% excreted in urine, 5-10% in feces within 72 hours.
- Half-life: Approximately 54 minutes.
Assessment
- Continuous monitoring of respiratory status until the risk of resedation diminishes (up to 120 minutes).
- The possibility of incomplete reversal of benzodiazepine-induced ventilatory insufficiency.
- Vigilant observation for seizures and implementing appropriate interventions.
Patient Education
- Advise against driving or engaging in hazardous activities for 18-24 hours after discharge.
- Alcohol and nonprescription drugs should be avoided for 18-24 hours post-administration if benzodiazepine effects linger.
- Consultation with a physician is necessary before breastfeeding while on this medication.
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Test your knowledge on FLUMAZENIL with these informative flashcards. Each card covers key aspects such as brand name, classification, and mechanism of action. Perfect for students in pharmacology and medicine.
