Benzodiazepine Antidote || Flumazenil in EMS
When the word antidote is brought up in the EMS field, most immediately think about narcan for a narcotic overdose. 💉There are actually tonssss of antidotes aside from narcan that we overlook at times like calcium, glucagon, hydroxocobalamin, sodium bicarbonate, etc. I actually made a post/video about this a few weeks ago if you are interested in learning more about antidotes.
There are a few antidotes that are mostly seen in hospitals with a very low chance of ever administering or even seeing in the prehospital setting. Flumazenil (aka Romazicon) is a great example of a medication/antidote that paramedic students are taught about, but most never get to see it administered. So let’s talk about it!
Flumazenil is given for benzodiazepine overdoses (examples of benzodiazepines are midazolam, lorazepam, diazepam, alprazolam, etc.). Flumazenil works by competitively binding to the GABA receptors and reducing the life-threatening central nervous system depression that benzodiazepine overdoses cause.
It is not to be used in an overdose of an unknown origin or of multiple medications (or seizure prone patients). It can be very dangerous if given to someone that may have overdosed on tricyclic antidepressants. The unpleasant, but commonly reported side effect of flumazenil is seizures 🧠. And what do we give for seizures???? EXACTLY!
I reached out to several medical professionals (doctors, NPs, nurses & medics) when researching flumazenil and they had no positive reports or witnessed reversal successes. I think we can and probably should count out ever carrying this medication in the 911 setting. 🚑🚨
Thoughts or comments???
🚨Disclaimer: This is not meant to be used as or in the place of professional medical advice. Remember to abide by your local protocol & stay within your scope of practice.
There are a few antidotes that are mostly seen in hospitals with a very low chance of ever administering or even seeing in the prehospital setting. Flumazenil (aka Romazicon) is a great example of a medication/antidote that paramedic students are taught about, but most never get to see it administered. So let’s talk about it!
Flumazenil is given for benzodiazepine overdoses (examples of benzodiazepines are midazolam, lorazepam, diazepam, alprazolam, etc.). Flumazenil works by competitively binding to the GABA receptors and reducing the life-threatening central nervous system depression that benzodiazepine overdoses cause.
It is not to be used in an overdose of an unknown origin or of multiple medications (or seizure prone patients). It can be very dangerous if given to someone that may have overdosed on tricyclic antidepressants. The unpleasant, but commonly reported side effect of flumazenil is seizures 🧠. And what do we give for seizures???? EXACTLY!
I reached out to several medical professionals (doctors, NPs, nurses & medics) when researching flumazenil and they had no positive reports or witnessed reversal successes. I think we can and probably should count out ever carrying this medication in the 911 setting. 🚑🚨
Thoughts or comments???
🚨Disclaimer: This is not meant to be used as or in the place of professional medical advice. Remember to abide by your local protocol & stay within your scope of practice.