Lorazepam overdose/flumazenil
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Reactions 1346 - 9 Apr 2011 O S Lorazepam overdose/flumazenil Coma followed by ventricular tachycardia: case report A 60-year-old man presented with probable benzodiazepine intoxication, received treatment with flumazenil and then developed ventricular tachycardia [times to reaction onsets not stated]. The man was brought to an ED after not awakening in the morning; he was intubated and suctioned. Examination revealed a comatose man with bilateral Babinski’s sign. He had a history of diabetic, cardiovascular and psychiatric illness, and had been receiving lorazepam intermittently. The man received naloxan [sic], which was not effective. The family revealed that they had found an empty 15-pill lorazepam pack by the man’s bed; he received flumazenil 0.2mg [route not stated] for probable benzodiazepine intoxication. Further doses of flumazenil were administered until, after a total dose of 3mg, he regained awareness. He received lidocaine and was extubated. Within seconds of extubation he developed pulsative ventricular tachycardia. The man received further lidocaine, which did not terminate his arrhythmia, then amiodarone which was successful. A subsequent ECG recording revealed sinus tachycardia with a heart rate of 108. Author comment: "We believe that this patient developed ventricular tachycardia due to flumazenil administration." Soleimanpour H, et al. Ventricular tachycardia due to flumazenil administration. Pakistan Journal of Biological Sciences 13: 1161-3, No. 23, Dec 2010 - Iran 803052367 1 Reactions 9 Apr 2011 No. 1346 0114-9954/10/1346-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Lorazepam overdose/flumazenil
Reactions 1346 - 9 Apr 2011
O SLorazepam overdose/flumazenil
Coma followed by ventricular tachycardia: casereport
A 60-year-old man presented with probablebenzodiazepine intoxication, received treatment withflumazenil and then developed ventricular tachycardia[times to reaction onsets not stated].
The man was brought to an ED after not awakening in themorning; he was intubated and suctioned. Examinationrevealed a comatose man with bilateral Babinski’s sign. Hehad a history of diabetic, cardiovascular and psychiatricillness, and had been receiving lorazepam intermittently.
The man received naloxan [sic], which was not effective.The family revealed that they had found an empty 15-pilllorazepam pack by the man’s bed; he received flumazenil0.2mg [route not stated] for probable benzodiazepineintoxication. Further doses of flumazenil were administereduntil, after a total dose of 3mg, he regained awareness. Hereceived lidocaine and was extubated. Within seconds ofextubation he developed pulsative ventricular tachycardia.
The man received further lidocaine, which did notterminate his arrhythmia, then amiodarone which wassuccessful. A subsequent ECG recording revealed sinustachycardia with a heart rate of 108.
Author comment: "We believe that this patient developedventricular tachycardia due to flumazenil administration."Soleimanpour H, et al. Ventricular tachycardia due to flumazenil administration.Pakistan Journal of Biological Sciences 13: 1161-3, No. 23, Dec 2010 -Iran 803052367
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Reactions 9 Apr 2011 No. 13460114-9954/10/1346-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
