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?
A. Seizures
B. Shivering
C. Anxiety
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.
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.
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.
Option D: An overdose of flumazenil in a patient who is not a chronic benzodiazepine user would not be expected. Chronic benzodiazepines users may experience withdrawal with abrupt discontinuation of the drug. Administration of benzodiazepines or barbiturates may be necessary for seizure control.