Which antidote is used for acute benzodiazepine overdose?

Which antidote is used for acute benzodiazepine overdose?

• A. Naloxone
• B. Physostigmine
• C. Flumazenil
• D. Vitamin K

Answer: (C)

Benzodiazepines enhance the inhibitory effect of GABA at the GABA-A receptor, so overdose leads to CNS depression and possible respiratory compromise. The antidote that directly reverses this effect is a drug that blocks the benzodiazepine binding site on the GABA-A receptor. Flumazenil does exactly that: it’s a competitive antagonist at the benzodiazepine site, displacing benzodiazepines and rapidly reversing sedation and respiratory depression in an acute overdose. Use of flumazenil is best in a controlled setting with careful monitoring because it can precipitate withdrawal and seizures in people who are benzodiazepine-dependent or who have mixed overdoses. It may not fully reverse effects if other sedatives are involved. Other options don’t target benzodiazepines: naloxone reverses opioid toxicity, physostigmine treats anticholinergic toxicity, and vitamin K is for coagulopathy, not benzodiazepine overdose.

Benzodiazepines enhance the inhibitory effect of GABA at the GABA-A receptor, so overdose leads to CNS depression and possible respiratory compromise. The antidote that directly reverses this effect is a drug that blocks the benzodiazepine binding site on the GABA-A receptor. Flumazenil does exactly that: it’s a competitive antagonist at the benzodiazepine site, displacing benzodiazepines and rapidly reversing sedation and respiratory depression in an acute overdose.

Use of flumazenil is best in a controlled setting with careful monitoring because it can precipitate withdrawal and seizures in people who are benzodiazepine-dependent or who have mixed overdoses. It may not fully reverse effects if other sedatives are involved.

Other options don’t target benzodiazepines: naloxone reverses opioid toxicity, physostigmine treats anticholinergic toxicity, and vitamin K is for coagulopathy, not benzodiazepine overdose.