benzodiazepine antagonists

see also benzodiazepines, toxicology

• may ppt withdrawal seizures → titrate dose & Rx 5mg IV midaz/diazepam;
• may remove protective anticonvulsant effect of benzodiazepines in multiple OD;
• re-sedation from overdose as duration of action is only 45-105min.
  • potential problem if patient discharges at own risk!!!
• thus, in general, these are NOT used in the Mx of polypharmacy overdose, or in patients who may be dependent on benzodiazepines.
• main use is to reverse acute excessive respiratory depressant effects of iatrogenic benzodiazepine excess.

• IV competitive antagonist;
• onset 30-60sec; T½=50min?; Clearance = 1L/min (all hepatic);