Flumazenil (Romazicon) has been ordered for a male client who has
overdosed on oxazepam (Serax). Before administering the medication,
nurse Gina should be prepared for which common adverse effect?
o A. Seizures
o B. Shivering
o C. Anxiety
o D. Chest pain
Correct Answer: A. Seizures
Seizures are the most common serious adverse effect of using
flumazenil to reverse benzodiazepine overdose. The effect is magnified
if the client has a combined tricyclic antidepressant and
benzodiazepine overdose. Benzodiazepine reversal has correlations
with seizures. Seizures may happen more frequently in patients who
have been on benzodiazepines for long-term sedation or in patients
who are showing signs of severe tricyclic antidepressant overdose. The
required dosage of Flumazenil should be measured and prepared by
the practitioners to manage seizures. Flumazenil use requires caution
in patients relying on a benzodiazepine for seizure control.
o Option B: Shivering is not an adverse effect of flumazenil.
Monitor the patient for the possible return of sedation, mostly in
those who are tolerant of benzodiazepines. Patients should have
monitoring for respiratory depression, benzodiazepine
withdrawal, and other residual effects of benzodiazepines for at
least 2 hours.
o Option C: Anxiety is a rare adverse effect for people using
flumazenil. Flumazenil has some associations with precipitation of
seizures in patients with benzodiazepine dependence with a
history of seizures. Flumazenil overdose is extremely rare. There
is no precise antidote for flumazenil toxicity. In mild to severe
toxicity, symptomatic and supportive treatment should be a
consideration.
o Option D: An overdose of flumazenil in a patient who is not
a chronic benzodiazepine user would not be expected. Chronic
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