Get 20M+ Full-Text Papers For Less Than $1.50/day. Start a 7-Day Trial for You or Your Team.

Learn More →

Complete Heart Block after Flumazenil:

Complete Heart Block after Flumazenil: Heart Block after Flumazenil Complete Barbara Herd & Fiona Clarke North Tees General Stockton on Cleveland Tees, Hospital, Flumazenil is a It is indicated for reversal of excess competitive benzodiazepine antagonist. under certain sedation the reversal of circumstances, benzodiazepine including overdosage effects when it is felt best avoid in to such as the old or the We ventilation, very very young. a case where the use of flumazenil was associated with heart block in an report complete elderly patient. Case history an A was admitted un- uneventful from her overdose. 79-year-old lady deeply recovery conscious. bottles of and serum was saved for Empty paracetamol Unfortunately, although , had been found at her bedside her it was error not stored temazepam by subsequent analysis, by husband who had found her unrousable when he frozen or out of so levels deep light, nifedipine awoke that She was to could not be measured. morning. unresponsive reliably had a heart rate of 84 beats min and a pain, blood 90/40 but she was warm pressure mmHg, Discussion and well Blood on air showed perfused. gases with an tension of 6.4 hypoventilation oxygen Flumazenil has been to be associated reported kPa and carbon dioxide of 4.8 kPa so she was with ventricular but there are no tachycardial2°3 treated with Her was oxygen. paracetamol level cases of heart block. As with cases reported 11 h after she was mg 1-1, approximately of ventricular the had taken arrhythmia, patient to have taken the overdose. presumed Acetyl a mixed almost overdose, certainly containing was therefore started. was trans- She cysteine amounts of and atenolol. significant nifedipine ferred to the ward and monitored. In order to try the of the Nonetheless, temporal relationship to reverse the effect of the 500 temazepam, mcg event to the administration of the flumazenil was of flumazenil was over several minutes. given and has been striking worrying. Bradycardia One minute after of the the injection completion after but not so reported flumazenil,2 directly monitor showed heart block at a rate of complete related to the administration of the drug. about 15 to 20 beats min-l. The was low pulse We are unable to provide any good explana- volume. The vomited patient effortlessly, tion for this event. The had overdose been clearly to no ill her heart rate fortunately effect, taken some hours before and it difficult to is increased to 30 to 50 beats min with first degree attribute a sudden onset of a bradycardia simply block and after intravenous she reverted atropine to atenolol and the as rate was nifedinpine pulse to sinus at a rate of 95 beats and rhythm min 1, reasonable and in sinus until the quite rhythm with a blood of 90 systolic pressure mmHg. received the flumazenil. Our patient experience Blood after this were satis- gases immediately reinforces the need for close of all monitoring with an tension of 16 kPa. Over factory oxygen such if flumazenil is to be used. patients the afternoon her heart rate fell to around again 55 and further was Blood atropine required. increased to 120/70 ECG pressure mmHg. References showed no from that recorded before the change event and cardiac were not elevated. Short T & DC. enzymes TG, Ventricular Maling Galletly arrhythmia flumazenil. British Medical Journal Her then returned with further precipitated by 296: 1988; family empty 1070-1. which had found at one bottles home, 2 they Burr & Sandham P. Death after flumazenil. British and the other and the atenolol nifedipine patient 298: 1713. Medical Journal 1989; admitted to taken these as Marchant Leach A & Nama M. having B, Wray R, Flumazenil subsequently convulsions and ventricular of her overdose. this causing British tachycardia. part Remarkably, lady Medical Journal 299: 860. 1989; minimal elevation of transaminase showed only normal and she which returned to made 27 November 20 (Received 1990; December rapidly accepted 1990) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Human and Experimental Toxicology SAGE

Complete Heart Block after Flumazenil:

Herd, Barbara; Clarke, Fiona
Human and Experimental Toxicology , Volume 10 (4): 1 – Jul 2, 2016
Download PDF
1 page

Loading next page...
 
/lp/sage/complete-heart-block-after-flumazenil-W8qMcH6dNa

References (4)

Publisher
SAGE
Copyright
Copyright © 2019 by SAGE Publications
ISSN
0960-3271
eISSN
1477-0903
DOI
10.1177/096032719101000409
Publisher site
See Article on Publisher Site

Abstract

Heart Block after Flumazenil Complete Barbara Herd & Fiona Clarke North Tees General Stockton on Cleveland Tees, Hospital, Flumazenil is a It is indicated for reversal of excess competitive benzodiazepine antagonist. under certain sedation the reversal of circumstances, benzodiazepine including overdosage effects when it is felt best avoid in to such as the old or the We ventilation, very very young. a case where the use of flumazenil was associated with heart block in an report complete elderly patient. Case history an A was admitted un- uneventful from her overdose. 79-year-old lady deeply recovery conscious. bottles of and serum was saved for Empty paracetamol Unfortunately, although , had been found at her bedside her it was error not stored temazepam by subsequent analysis, by husband who had found her unrousable when he frozen or out of so levels deep light, nifedipine awoke that She was to could not be measured. morning. unresponsive reliably had a heart rate of 84 beats min and a pain, blood 90/40 but she was warm pressure mmHg, Discussion and well Blood on air showed perfused. gases with an tension of 6.4 hypoventilation oxygen Flumazenil has been to be associated reported kPa and carbon dioxide of 4.8 kPa so she was with ventricular but there are no tachycardial2°3 treated with Her was oxygen. paracetamol level cases of heart block. As with cases reported 11 h after she was mg 1-1, approximately of ventricular the had taken arrhythmia, patient to have taken the overdose. presumed Acetyl a mixed almost overdose, certainly containing was therefore started. was trans- She cysteine amounts of and atenolol. significant nifedipine ferred to the ward and monitored. In order to try the of the Nonetheless, temporal relationship to reverse the effect of the 500 temazepam, mcg event to the administration of the flumazenil was of flumazenil was over several minutes. given and has been striking worrying. Bradycardia One minute after of the the injection completion after but not so reported flumazenil,2 directly monitor showed heart block at a rate of complete related to the administration of the drug. about 15 to 20 beats min-l. The was low pulse We are unable to provide any good explana- volume. The vomited patient effortlessly, tion for this event. The had overdose been clearly to no ill her heart rate fortunately effect, taken some hours before and it difficult to is increased to 30 to 50 beats min with first degree attribute a sudden onset of a bradycardia simply block and after intravenous she reverted atropine to atenolol and the as rate was nifedinpine pulse to sinus at a rate of 95 beats and rhythm min 1, reasonable and in sinus until the quite rhythm with a blood of 90 systolic pressure mmHg. received the flumazenil. Our patient experience Blood after this were satis- gases immediately reinforces the need for close of all monitoring with an tension of 16 kPa. Over factory oxygen such if flumazenil is to be used. patients the afternoon her heart rate fell to around again 55 and further was Blood atropine required. increased to 120/70 ECG pressure mmHg. References showed no from that recorded before the change event and cardiac were not elevated. Short T & DC. enzymes TG, Ventricular Maling Galletly arrhythmia flumazenil. British Medical Journal Her then returned with further precipitated by 296: 1988; family empty 1070-1. which had found at one bottles home, 2 they Burr & Sandham P. Death after flumazenil. British and the other and the atenolol nifedipine patient 298: 1713. Medical Journal 1989; admitted to taken these as Marchant Leach A & Nama M. having B, Wray R, Flumazenil subsequently convulsions and ventricular of her overdose. this causing British tachycardia. part Remarkably, lady Medical Journal 299: 860. 1989; minimal elevation of transaminase showed only normal and she which returned to made 27 November 20 (Received 1990; December rapidly accepted 1990)

Journal

Human and Experimental Toxicology – SAGE

Published: Jul 2, 2016

There are no references for this article.