Benzodiazepine Overdose

Benzodiazepine Overdose General Information

The benzodiazepines are also called shortly benzos and represent a class of psychoactive drugs that are taken as minor tranquilizers. Their properties may vary from anticonvulsant, hypnotic, anxiolytic, amnesic, and sedative which result from a slowing down o the CNS (central nervous system). In Benzodiazepine Overdose, these properties have a lot of adverse effects causing really serious damages to the overdosed. Benzodiazepine Overdose comes from treating alcohol withdrawal, insomnia, seizure, anxiety, muscle spasms, and agitation with big doses of these psychoactive drugs. Doctors use them before certain medical procedures, for example dental work or endoscopies, where anxiety and tension are present in patients. Using them is prior to medical procedures that are very unpleasant, inducing amnesia and sedation required by the respective procedure. Benzodiazepines are used as means of “coming down” by persons who consume recreational stimulants. When these medicines are used for a long-term, they lead to a physical dependence, Benzodiazepine Overdose. This is why benzodiazepines should never be used without a medical consultation and only after the doctor prescribed it to you. Usually the drugs must be given or taken in the smallest dosage recommended in order to prevent overdoses and the resulting symptoms. All dependences of these drugs are different and vary from user to user and with the benzodiazepine used. Most drugs from this class are given orally, but some of them can be administrated intramuscularly, as a suppository, intravenously, or sublingually. The most common benzodiazepines are: bromazepam, diazepam, lorazepam, alprazolam, chlordiazepoxide, estazolam, nitrazepam, clonazepam, oxazepam, flunitrazepam, lormetazepam, triazolam, midazolam, temazepam, flurazepam, and bromazepam.

Benzodiazepine Overdose Symptoms

Benzodiazepine Overdose can be mild and severe and differs from user to user and with the dose of drug taken. Some symptoms of a mild overdose are: impaired coordination, unsteady balance, lethargy, drowsiness, euphoria, diminished reflexes, confusion and a slurred speech. Severe reactions after a serious Benzodiazepine Overdose may be considered a low pressure of the blood, seizure, hypotonia, respiratory arrest, when breathing stops, ataxia, vomiting stomach contents in lungs, hypotension, stupor, and worse, coma. There have been reported cardiac arrests, but the death does not come if ingestion of other CNS depressants and alcohol has not occurred. In the first days of therapy after an overdose with benzodiazepines may appear tiredness, lightheadedness and weakness that may decrease if the treatment continues. If they persist, the dosage must be immediately reduced. A class of patient may be very sensitive to the CNS effects, for example the children, debilitated patients, the persons with low serum albumin or liver disease, and the elderly. There can also be reported in few patients really serious adverse effects such as mental depression, leucopenia, behavioral problems, memory impairment, phlebitis or venous thrombosis, hypersensitivity reactions, jaundice, or paradoxical stimulant reactions. The effects of an overdose can include increased bronchial secretions or watering of mouth, abdominal or stomach cramps or pain, dry mouth, tachycardia or palpitations, sexual dysfunction, vivid or disturbing dreams, trembling, blurred vision or diplopia, vertigo, incontinence, syncope, nausea or vomiting, increased thirst, constipation, urinary retention, confusion, headache, or diarrhea. The overdoses with these kinds of drugs are not that serious than the many others because the mortality rate is not that big.

Benzodiazepine Overdose Treatment

If you suspect someone of having Benzodiazepine Overdose, call urgent to 911 because if it is left untreated this condition ends with the death of the individual. Take the affected one to a poison control center or to a toxicologist and if his health status is really serious altered, to an intensive care specialist. If the patient has attempted suicide, it is better to take him to a psychiatrist to make sure he would not do that again and to see how damaged his mental status is. Although Benzodiazepine Overdose is said to be safe, mostly to the fact that the patients are managed in the ED, there were reported enough cases of dead patients that could determine you think twice before consuming a higher dose of one of the benzodiazepines. When seeing a doctor, he or she will first focus on the neurological and cardio respiratory function and on your vital signs (decreased respiratory rate, decreased oxygen saturation level and hypotension). A very high importance has it the prehospital care. This consists in: giving to the patient the necessarily supply of oxygen, determining fast his or hers glucose, the intravenous access, cardiac monitoring, or giving naloxone in the case that the patient has not got a clear diagnose or if he is suspected of an opiate co-ingestion.

When arriving to the emergency department care, the patient, stable or not, must be still monitored for vital signs, oximetry, IV, or heart and must receive supportive care which is also the most important aspect of the management of Benzodiazepine Overdose. Next, follows the decontamination of the patient by gastric lavage or with a single-dose activated charcoal that absorbs the orally ingest agents even after 4-5 hours of ingestion. Assisted ventilation is used when the patient may suffer from a respiratory depression. If the level of consciousness is decreased along with the respiratory insufficiency, the airways must be closely and safely controlled. There are patients who can not breathe consistently on their own and are not capable to maintain airways so that they may need endotracheal intubations. All patients need intravenous access because of the instability of some. As in the cases of so many others overdoses, the attempt of minimizing the toxicological effects is necessary. Although in other types of overdoses dialysis is really helpful, in Benzodiazepine Overdose this can not do much good because of the high level of protein binding and large volume distribution. The most efficient medicine that works against Benzodiazepine Overdose is flumazenil which is a very competitive antagonist of the GABA receptor although its use is controversial. A patient could develop significant secondary effects. Or flumazenil is used cautiously, or not at all. This drug must not be used as part of a coma cocktail or routinely. If the adequate therapy is given, the overall prognosis is really good. The complications of a prolonged apnea or co-ingestion lead to death.