An interprofessional team approach would help achieve maximum efficacy and minimize potential risks associated with flumazenil therapy. Most importantly, a person overdosing on Ativan can experience breathing issues, which can lead to heart attack, coma and death. Such confusion can lead to erratic, unforeseen behavior. As depicted above, clinicians(MDs, DOs, NPs, PAs) should collaborate to improve patient outcomes. Memory loss: Lorazepam is used to prevent new memories from forming during surgery, and this effect may translate over during an overdose state. In addition, medical toxicologist consultation is often required for multiple-drug ingestions. Critical care physician consultation is required in severe poisoning with respiratory depression. Hospital pharmacists should ensure proper dosing of flumazenil. Emergency department physicians should rapidly stabilize the patient. Normally flumazenil overdose is handled by emergency department physicians. Flumazenil (Romazicon) is the antidote for benzodiazepines, such as diazepam (Valium), lorazepam (Ativan), and midazolam (Versed), and must be administered intravenously. Overall, the use of flumazenil to manage benzodiazepine overdose is diminishing as the drug may cause more harm than good. A few patients may develop rhabdomyolysis and aspiration pneumonia. In most isolated cases of benzodiazepine overdose, supportive management may prove useful. The problem arises when the individual has co-ingested alcohol or other illicit drugs. In general, patients who overdose on benzodiazepines alone rarely have significant mortality. The nurse and the pharmacist should educate the patient on the use of benzodiazepines, their potential to cause addiction, and physical dependence. The ideal circumstance for flumazenil is when a naive benzodiazepine individual has overdosed. Additionally, all healthcare workers need to know that this drug should not be used in patients with a history of seizures, head injury, or those who have ingested a tricyclic antidepressant. The drug may precipitate seizures and withdrawal in patients who have been using benzodiazepines for a medical disorder. Not everyone with benzodiazepine overdose will respond to it. The problem with flumazenil is that its effects are not consistent or predictable. Despite the initial hype about the drug, many experts believe that its risks may outweigh its benefits. This competitive antagonist of benzodiazepines can rapidly reverse benzodiazepine overdose. Today, with the epidemic of drug overdoses, nurses, pharmacists, and physicians need to be aware of flumazenil. Lorazepam, 2 to 4 mg IV every 15 to 20 minutes, can also be used, but the longer interval required to wait to determine a peak effect of lorazepam almost contradicts the concept of front loading.
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