Kyong Yeon Young, Park Jeng Tak, Choi Kyoung Ho
Department of Emergency Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Department of Emergency Medicine, Uijeongbu St Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
Am J Emerg Med. 2014 Nov;32(11):1438.e5-6. doi: 10.1016/j.ajem.2014.04.004. Epub 2014 Apr 13.
Benzodiazepines are widely used for many diseases, and benzodiazepine overdose is globally increasing in proportion to its prescriptions. Although most benzodiazepine overdoses are known to be safe and nonfatal without coingestions, morbidity or mortality after benzodiazepine overdose is closely related with the duration of unconsciousness or depth of compromised airway. Proper use of flumazenil, a potent antidote of benzodiazepine, seems to accelerate the recovery from the toxicity after benzodiazepine overdose.However, as the case we present demonstrates, careful attention and repetitive evaluations before and after use of flumazenil may be needed in benzodiazepine overdose because resedation occurs in approximately 30% of total flumazenil-treated cases, which suggests that the risk of aspiration or incidental death after administrating flumazenil might be significant without careful monitoring.
苯二氮䓬类药物被广泛用于多种疾病的治疗，并且苯二氮䓬类药物过量服用的情况在全球范围内随着其处方量的增加而增多。尽管已知大多数单纯服用苯二氮䓬类药物过量的情况是安全且非致命的，但在同时摄入其他物质的情况下，苯二氮䓬类药物过量服用后的发病率或死亡率与昏迷持续时间或气道受损程度密切相关。正确使用苯二氮䓬类药物的强效解毒剂氟马西尼似乎能加速苯二氮䓬类药物过量服用后毒性的恢复。然而，正如我们所呈现的病例所示，在苯二氮䓬类药物过量服用的情况下，使用氟马西尼前后可能需要密切关注并进行反复评估，因为在接受氟马西尼治疗的病例中，约30%会再次出现镇静状态，这表明如果没有仔细监测，服用氟马西尼后发生误吸或意外死亡的风险可能很大。
