A poison center's ten-year experience with flumazenil administration to acutely poisoned adults.

Abstract

BACKGROUND:

The frequency of seizures among acutely poisoned adults who are administered flumazenil has not been well established.

STUDY OBJECTIVE:

The objectives of the study were: to determine the frequency of seizures among acutely poisoned adults administered flumazenil; to identify factors associated with seizures; and to determine the mental status of subjects before and after administration of flumazenil.

METHODS:

This study was a historical case series of acutely poisoned adults reported to a poison control system from 1999 to 2008. Included cases were those involving administration of flumazenil to subjects who were ≥ 18 years of age. Both genders were included. Variables collected included: presence of seizure or death, exposure to a pro-convulsant drug, and mental status before and after flumazenil administration.

RESULTS:

Over the 10-year period studied, 904 cases were identified that met inclusion criteria. Thirteen subjects (1.4%) developed seizures after flumazenil was administered. One death occurred. There were 293 subjects exposed to a pro-convulsant drug, and 8 of these had seizures after flumazenil administration. Development of seizures after flumazenil administration was significantly associated with exposure to a pro-convulsant drug (odds ratio 3.41; 95% confidence interval 1.13-10.72). Mental status before and after flumazenil administration was available for 546 subjects (60.3%). Of these, 291 (53.3%) became awake after administration of flumazenil.

CONCLUSIONS:

Flumazenil administration to acutely poisoned adults resulted in a low frequency of seizures and death. Development of seizures was associated with exposure to a pro-convulsant drug. More than half of the subjects for whom mental status was recorded became awake after receiving flumazenil.

• Authors: Allyson A Kreshak, F Lee Cantrell, Richard F Clark, Christian A Tomaszewski
• Journal: The Journal of emergency medicine (J Emerg Med) Vol. 43 Issue 4 Pg. 677-82 (Oct 2012) ISSN: 0736-4679 [Print] United States
• PMID: 22766408 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antidotes
• Convulsants
• Hypnotics and Sedatives
• Benzodiazepines
• Flumazenil

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Antidotes (adverse effects, therapeutic use)
• Benzodiazepines (poisoning)
• California
• Confidence Intervals
• Consciousness
• Convulsants (poisoning)
• Female
• Flumazenil (adverse effects, therapeutic use)
• Humans
• Hypnotics and Sedatives (poisoning)
• Male
• Middle Aged
• Odds Ratio
• Seizures (chemically induced)
• Time Factors
• Young Adult