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Drug Overdose and Antidotes

Drug Overdose and Antidotes

Sample Answer 

Drug Overdose and Antidotes

A drug overdose occurs when the amount of drug in the body system is higher than the required levels, affecting normal physiological functioning. Symptoms of drug overdose vary depending on the drug taken (Moore PW et al., 2014). An antidote is a substance that counteracts a poison, neutralizing its physiological effects. There are four classes of antidotes based on their mechanism of action: chemical antidote, physical antidote, physiologic antidote, and universal antidote.

For this discussion, I selected flumazenil, the diazepam antidote. According to a study by (Cook et al., 2018), flumazenil is likely to be used more by whites as compared to blacks and Asians due to their higher dependence rate on benzodiazepine as compared to the other races. Diazepam is a positive allosteric modulator of GABA type A receptor and acts by facilitating GABA action, an inhibitory neurotransmitter in the central nervous system, which results in reduced brain arousal. On the other hand, flumazenil is an antagonist for benzodiazepines, which acts by competitively inhibiting the action of diazepam on its recognition site on the GABA receptor.

Diazepam overdose may arise from an abuse of the drug for its central nervous system effects, and as a result, this may lead to adverse effects such as persistent drowsiness, fatigue, anxiety, seizures, and hallucinations. In a diazepam overdose, flumazenil is initially administered at a dose of 0.2mg IV for 15-30 seconds. If there is no response after 1 minute, a dose of 0.3mg IV is administered over 30 seconds. If there is still no response, a repeat dose of 0.5mg IV is administered over 30 seconds at 1-minute intervals to a maximum cumulative dose of 3mg/h (Vasilevskis EE et al., 2012).

Research studies done on flumazenil use as an antidote show that it’s not routinely used because of fear of seizures and withdrawals and because most patients suffering from sedation are due to a combination of prescription medications. The case studies showed a higher positive response rate with few or no adverse effects. Due to few clinically significant adverse effects, flumazenil serves as a good therapeutic antidote (Moore PW et al., 2014).

References

Cook, B., Creedon, T., Wang, Y., Lu, C., Carson, N., Jules, P., Lee, E., & Alegría, M. (2018). Examining racial/ethnic differences in patterns of benzodiazepine prescription and misuse. Drug and alcohol dependence, 187, 29–34. https://doi.org/10.1016/j.drugalcdep.2018.02.011

Moore, P. W., Donovan, J. W., Burkhart, K. K., Waskin, J. A., Hieger, M. A., Adkins, A. R., Wert, Y., Haggerty, D. A., & Rasimas, J. J. (2014). Safety and efficacy of flumazenil for reversal of iatrogenic benzodiazepine-associated delirium toxicity during treatment of alcohol withdrawal, a retrospective review at one center. Journal of medical toxicology: official journal of the American College of Medical Toxicology, 10(2), 126–132. https://doi.org/10.1007/s13181-014-0391-6

Vasilevskis, E. E., Han, J. H., Hughes, C. G., & Ely, E. W. (2012). Epidemiology and risk factors for delirium across hospital settings. Best practice & research. Clinical anaesthesiology, 26(3), 277–287. https://doi.org/10.1016/j.bpa.2012.07.003

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Question 


Drug Overdose and Antidotes

Select an antidote for a medication overdose. Determine if there are any ethnic, cultural, or genetic differences that need to be considered using these medications. Discuss the mechanism of action of both agents, the risks of the overdose, and the dosing of antidotes. Share a patient case in which this antidote was used and discuss the success or failure of the agent. Include the name of the medication in the subject line so that the medications can be followed. Include references in APA format.

Drug Overdose and Antidotes

Drug Overdose and Antidotes

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