BZD reversal

 Q: What is the maximum dose of Flumazenil which can be administrated in an hour? (select one)

A) 1 mg

B) 3 mg

C) 5 mg

Answer: B

Flumazenil is frequently used in ICU to reverse the effect of benzodiazepine (BZD). The major hurdle in it's success is its shorter half life in comparison to BZD, and repeated doses may be required. One of the risk factor with higher dose of Flumazenil is seizures. Ideally, no more than 1 mg should be used but in extreme situation no more than 3 mg should be given within an hour. It is usually administrated in divided doses of 0.2 mg each time and each dose should be pushed slowly over 30-40 seconds.

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Reference:

Sharbaf Shoar N, Bistas KG, Saadabadi A. Flumazenil. [Updated 2020 Sep 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470180/