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Terms in this set (112)

• Secure the airway and IV access before starting benzodiazepine antagonist therapy.
• Prepare to administer flumazenil (Romazicon)* in a dose of 0.2 mg to 1 mg IV.
• Repeat drug every 2 to 3 minutes up to 3 mg, as needed, depending on the patient's response.
• Give oxygen if hypoxia is present or if respirations are below 10 breaths per minute.
• Have suction equipment available because flumazenil can trigger vomiting and a drowsy patient is at risk for aspiration.
• Continuously monitor vital signs and level of consciousness for reversal of overdose.
• Do not leave the patient until he or she is fully responsive.
• Continue to monitor the patient's vital signs and level of consciousness every 10 to 15 minutes for the first 2 hours because flumazenil is eliminated from the body more quickly than is the benzodiazepine.
• Determine the need for additional flumazenil therapy 1 to 2 hours after the patient initially becomes fully responsive.
• Observe the patient for tremors or convulsions because flumazenil can lower the seizure threshold in patients who have seizure disorders.
• Assess the IV site every shift because flumazenil can cause thrombophlebitis at the injection site.
• Observe the patient for side effects of flumazenil, including skin rash, hot flushes, dizziness, headache, sweating, dry mouth, and blurred vision. The incidence of these side effects increases with higher total doses of flumazenil.
*There are other benzodiazepine antagonists; however, flumazenil is used most often to manage adult benzodiazepine overdose in the postoperative period.