Hung D Z, Huang F J, Deng J F, Tsai W J
National Poison Center, Veterans General Hospital-Taipei.
Zhonghua Yi Xue Za Zhi (Taipei). 1991 Dec;48(6):485-8.
Ethanol possesses anxiolytic and anticonflict effect in low dose, but exhibits consciousness depression in higher serum level. It also has addictive effects on benzodiazepines (BZD) and its mechanism has been thought to be closely related to GABA-BZD receptor complex. Flumazenil is a well-known potent antagonist in benzodiazepine intoxication. It can restore the patients' consciousness in case of BZD overdose in comatose condition. In the treatment of ethanol intoxication, flumazenil has not been well-accepted as an antidote. We report a case of severe ethanol intoxication (serum level: 512 mg/dl) with deep coma. Flumazenil 0.5 mg restored her consciousness 90 mins after antidote had been administrated. According to the literature, improvement of conscious level was not due to decay of serum ethanol level but flumazenil itself, which has potential benefit to the condition of ethanol intoxication. This effect is delayed as compared with its using in BZD overdose.
乙醇在低剂量时具有抗焦虑和抗冲突作用,但在血清水平较高时会表现出意识抑制。它对苯二氮䓬类药物(BZD)也有成瘾作用,其机制被认为与GABA-BZD受体复合物密切相关。氟马西尼是苯二氮䓬类药物中毒时一种著名的强效拮抗剂。在昏迷状态下BZD过量时,它可以恢复患者的意识。在乙醇中毒的治疗中,氟马西尼作为解毒剂尚未被广泛接受。我们报告一例严重乙醇中毒(血清水平:512mg/dl)伴深度昏迷的病例。给予解毒剂后90分钟,0.5mg氟马西尼使她恢复了意识。根据文献,意识水平的改善并非由于血清乙醇水平下降,而是氟马西尼本身的作用,这对乙醇中毒状况有潜在益处。与用于BZD过量时相比,这种作用延迟出现。