Every practicing professional has their own way of keeping informed on the latest and greatest in their chosen field. The desire for lifetime learning is one of the cornerstones of higher education. Some use journals, others electronic newsletters. But it seems that everyday there is another paper published that impacts pharmacy. As a member of the American Academy of Clinical Toxicology I receive a monthly "Current Awareness" newsletter that lists important papers published in the last month. My September current awareness includes, "A Poison Center's Ten-year Experience with Flumazenil Administration to Acutely Poisoned Adults". Perfect timing! Last Wednesday I talked about the use of flumazenil as a benzodiazepine antagonist in the poisoned patient. This paper is now posted on Angel in the "readings" folder. The conclusion you heard last week was that the flumazenil is rarely used due to the risk of seizures. This paper reviewed 904 patients who received flumazenil. Of those patients 13 had a seizure and one died. So the seizure rate is actually low. The authors conclude that only 13/904 (1.3 %) of patients developed seizures and that those seizures were significantly associated with the ingestion of a medication that is pro-convulsants. The authors also also note that most of the patients had an improved mental status after flumazenil administration. So what did I learn from this that I can carry into my practice? Flumazenil does work, but its risks are significant. Each patient must be very carefully screened before it can be administered. The ingestion of a pro-convulsant drug would be an absolute contraindication to flumazenil.
Lifetime learning, so what are your plans?
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