Reactions 553 - 3 Jun 1995

SLorazepam overdose

CNS disorders treated with flumazenil in a child:case report

The effects of flumazenil in reversing the adverse effects ofbenzodiazepine overdose have been well described in adults,but little data are available in children. The following casereport describes a child with lorazepam poisoning whoresponded to flumazenil.

The 3-year-old girl ingested up to 29 tablets of lorazepam0.5mg. On arrival at hospital half an hour later she waslethargic and was given activated charcoal.

Approximately 7 hours after the ingestion of lorazepam thegirl became progressively more lethargic, responding only topainful stimuli, and she only had periodic respirations. Within10 minutes after IV flumazenil 0.2mg was given, the girlbecame alert and her respiratory function improved and sherecovered uneventfully. Nine hours after the ingestion, herblood lorazepam level was 147 ng/ml (therapeutic range20–240).

Author comment: ‘This case demonstrates a potentialdelayed reaction of lorazepam. There is no previous report ofthis response to lorazepam . . . The mechanism of the observeddelayed symptoms is unclear.’Clark RF, et al. Delayed onset lorazepam poisoning successfully reversed byflumazenil in a child: case report and review of the literature. Pediatric EmergencyCare 11: 32-34, Feb 1995 - USA 807070980

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Reactions 3 Jun 1995 No. 5530114-9954/10/0553-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved