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Benzodiazepine
poisoning (Clinical
presentation (Reduced…
Benzodiazepine
poisoning
-
Pathophysiology
-
Potentiate effect of other CNS depressants
(alcohol, TCA, barbituates)
-
-
Diagnosis
History
PC/HPC
Drugs taken, dose, timing,
intention, symptoms, any vomiting,
any other drugs e.g. alcohol
PMH
Psychiatric history,
known medical conditions
DH
Meds (prescripted, OTC, illicit), allergies
SH
Living arrangements, occupation,
alcohol, illicit drugs, smoking
Examination
-
Neuro
dyarthria, ataxia, reduced GCS,
nystagmus, drowsy
Investigations
Bloods
ABG, FBC, U+E, LFTs, toxicology
-
Bedside
Obs (low RR, may have low BP)
ECG
Management
-
Definitive
Conservative
Information, advice, support
Monitoring (obs, neuro, cardiac)
Check TOXBASE
Medical
Gastric lavage
Indication: <1h, mixed OD, benzo dependence
MOA: reduces absorption by removal from stomach
Benzodiazepine antagonist
Indication: specialist use
E.g. flumazenil
MOA: antagonises benzos
SEs: arrhythmia, seizure, withdrawal (if dependent)
CIs: mixed OD, benzo dependence (adverse psych effects)