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Benzodiazepine Overdose

Benzodiazepine Overdose is a topic covered in the Pocket ICU Management.

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First Things First (assess & Treat For The Following)

  • Assess and treat the ABCs
    • Primary manifestation of benzodiazepine intoxication/overdose is mental status depression; in severe cases, cardiorespiratory depression may also occur.
    • Aggressive/expectant airway management for frank/anticipated inadequacy of protective airway reflexes
    • Supine/Trendelenburg positioning and aggressive IV fluid therapy for hypotension
  • GI decontamination
    • Activated charcoal 1 g/kg PO or per NG tube is effective in most cases if administered early.
    • Initiate gastric lavage for clinically significant recent ingestions (ie, within 30 minutes).
    • Ensure/monitor airway patency/protective reflexes during the above treatments.
  • Further therapy and immediate considerations
    • Supportive care is the cornerstone of treatment.
    • Evaluate for possible flumazenil administration, especially in life-threatening intoxications.
    • Evaluate for other toxin/CNS depressant involvement and initiate appropriate diagnostic/treatment plans.
    • Consider IV naloxone in setting of mixed overdose/intoxication (will not reverse benzodiazepine-induced cardiorespiratory depression).
    • Evaluate for the specific benzodiazepine ingested/administered, in particular to determine its half-life. Shorter half-life benzodiazepines are associated with increased morbidity/mortality.

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Last updated: April 9, 2010


"Benzodiazepine Overdose." Pocket ICU Management, PocketMedicine.com, Inc, 2010. Anesthesia Central, anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534254/all/Benzodiazepine_Overdose.
Benzodiazepine Overdose. Pocket ICU Management. PocketMedicine.com, Inc; 2010. https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534254/all/Benzodiazepine_Overdose. Accessed April 22, 2019.
Benzodiazepine Overdose. (2010). In Pocket ICU Management. Available from https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534254/all/Benzodiazepine_Overdose
Benzodiazepine Overdose [Internet]. In: Pocket ICU Management. PocketMedicine.com, Inc; 2010. [cited 2019 April 22]. Available from: https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534254/all/Benzodiazepine_Overdose.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Benzodiazepine Overdose ID - 534254 Y1 - 2010/04/09/ BT - Pocket ICU Management UR - https://anesth.unboundmedicine.com/anesthesia/view/Pocket-ICU-Management/534254/all/Benzodiazepine_Overdose PB - PocketMedicine.com, Inc DB - Anesthesia Central DP - Unbound Medicine ER -