ToxicologyEmergency
Benzodiazepine overdose
Supportive management of benzodiazepine overdose; selective use of flumazenil.
Source: TOXBASE/NPIS; AACT/EAPCCT
Step 1 of ~5
action
Initial assessment
ABCDE. Pure benzodiazepine overdose is rarely fatal; severe toxicity usually reflects co-ingestion (alcohol, opioids, TCAs).
Features: drowsiness, ataxia, slurred speech, hypotonia. Severe: respiratory depression, hypotension, hypothermia.
Bloods: VBG, glucose, U&E, paracetamol/salicylate, alcohol level if ingested. ECG. Identify co-ingestants.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- FlumazenilRecommendedBenzodiazepine Antagonist
- DiazepamRecommendedBenzodiazepine (long-acting)
- LorazepamRecommendedBenzodiazepine
- MidazolamRecommendedBenzodiazepine
Same class
Pathways
- Paracetamol overdose · TOXBASE/NPIS; MHRA DSU 2012/2024; SNAP regimen (Lancet 2014)
- TCA overdose · TOXBASE/NPIS; AACT/EAPCCT position statements; Resuscitation Council UK ALS
- Opioid overdose · TOXBASE/NPIS; Resuscitation Council UK
- Anticholinergic toxidrome · TOXBASE/NPIS; AACT/EAPCCT
- β-blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC
- Calcium channel blocker overdose · TOXBASE/NPIS; AACT/EAPCCT; ESC
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Decision support only. Always apply local guidelines and clinical judgement.