ইঙ্গিত ও ব্যবহার
Anexate is indicated for reversal of the centrally sedative effects of benzodiazepines. It should therefore be used in anaesthesia and intensive care in the following indications:In anaesthesia- Termination of general anaesthesia induced and maintained with benzodiazepines in inpatients. ... Read moreAnexate is indicated for reversal of the centrally sedative effects of benzodiazepines. It should therefore be used in anaesthesia and intensive care in the following indications:In anaesthesia- Termination of general anaesthesia induced and maintained with benzodiazepines in inpatients. Reversal of benzodiazepine sedation in short diagnostic and therapeutic procedures in both inpatients and outpatients. Reversal of paradoxical reactions due to benzodiazepines. In intensive care and in the management of unconsciousness of unknown origin- For the diagnosis and/or management of benzodiazepine overdose due to self-poisoning or accidental overdose. As a diagnostic measure in unconsciousness of unknown origin to differentiate between involvement of benzodiazepines, other medicines or drugs or brain damage. Anexate may also be used for specific reversal of the central effects of benzodiazepines in drug or medicine overdose (return to spontaneous respiration and consciousness in order to render intubation unnecessary or allow extubation)
ডোজ নির্দেশিকা
শুধুমাত্র নির্দেশিকা তথ্য
প্রদর্শিত ডোজগুলি সরকারি উৎসের সাধারণ নির্দেশিকা। ব্যক্তিগতকৃত ডোজের জন্য সর্বদা আপনার ডাক্তার বা ফার্মাসিস্টের পরামর্শ নিন।
Adults:
Flumazenil is recommended for intravenous (IV) use only and should be administered by an anaesthesiologist or an experienced physician. In anaesthesia: The recommended initial dose of Flumazenil is 0.2 mg, administered IV over 15 seconds. If the desired degree of consciousness is not obtained within 60 seconds, a second dose of 0.1 mg can be injected. This may be repeated at 60 second intervals where necessary, up to a total dose of 1 mg. The usual dose is 0.3 to 0.6 mg, but individual requirements may vary considerably, depending on the dose and duration of effect of the benzodiazepine administered and on patient characteristics. In intensive care and in the management of unconsciousness of unknown origin: The recommended initial dose of Flumazenil is 0.3 mg IV. If the desired level of consciousness is not obtained within 60 seconds, Flumazenil may be injected repeatedly until the patient awakes, up to a total dose of 2 mg. If drowsiness recurs, Flumazenil may be given as one or more bolus IV doses as above, or as an IV infusion of 0.1 to 0.4 mg per hour. The rate of infusion should be adjusted individually to the desired level of arousal. If repeated doses of Flumazenil do not bring a significant improvement in consciousness or respiratory function, a non benzodiazepine cause must be assumed. In the intensive care unit, in patients treated with high doses of benzodiazepines and/or for long periods, individually titrated injections of Flumazenil, given slowly, should not produce withdrawal symptoms. If unexpected symptoms occur, diazepam or midazolam can be carefully titrated intravenously according to the patient's response. Children above 1 year of age: For reversing conscious sedation induced with benzodiazepines in children above one year of age, the recommended initial dose is 0.01 mg/kg (up to 0.2 mg), administered IV over 15 seconds. If the desired level of consciousness is not obtained after an additional 45 seconds, further injections of 0.01 mg/kg (up to 0.2 mg) can be given and repeated at 60 second intervals where necessary, up to a maximum of four additional times, to a maximum total dose of 0.05 mg/kg or 1 mg, whichever is lower. The dose should be individualised based on the patient's response. No data are available on the safety and efficacy of repeated administration of Flumazenil to children for re sedation.
পার্শ্বপ্রতিক্রিয়া
Resurge is well tolerated in adults and children. In adults, Resurge is well tolerated even at doses exceeding those recommended. Hypersensitivity reactions, including anaphylaxis, have been observed. Complaints such as feelings of anxiety, palpitations and fear have been infrequently observed after rapid injection of Resurge. These adverse effects usually do not necessitate special treatment. Seizures have been reported in patients known to suffer from epilepsy or severe hepatic impairment, particularly after long-term treatment with benzodiazepines or in cases of mixed- substance overdose. In cases of mixed-substance overdose, particularly with cyclic antidepressants, toxic effects (such as convulsions and cardiac dysrhythmias) may emerge with the reversal of benzodiazepine effects by Resurge. Withdrawal symptoms may occur following rapid injection of Resurge in patients with long-term exposure to benzodiazepines ending at any time within the weeks preceding Resurge administration. Resurge has been reported to provoke panic attacks in patients with a history of panic disorders.
সতর্কতা ও নিষেধাজ্ঞা
Warnings & Precautions
Particular caution is necessary when using Resurge in cases of mixed substance overdose, since the toxic effects (such as convulsions and irregular heart rhythms) of other medicines taken in overdose, especially cyclic antidepressants, may emerge once Resurge reverses the effects of the benzodiazepine. The use of Resurge is not recommended in epileptic patients who have been receiving benzodiazepine treatment for a prolonged period. Although Resurge exerts a slight anticonvulsant effect of its own, its abrupt suppression of the protective effect of a benzodiazepine agonist can bring on convulsions in epileptic patients. Patients who have received Resurge for the reversal of benzodiazepine effects should be monitored for resedation, respiratory depression or other residual benzodiazepine effects for a suitable period, based on the dose and duration of effect of the benzodiazepine used. Since patients with underlying liver impairment may experience delayed benzodiazepine effects, a longer observation period may be needed. When Resurge is used together with neuromuscular blocking agents, it should not be injected until the effects of the neuromuscular block have been fully reversed. Resurge should be used with caution in patients with head injury, as it may be capable of triggering convulsions or altering cerebral blood flow in patients receiving benzodiazepines. Rapid injection of Resurge should be avoided in patients who have had high dose and/or long term exposure to benzodiazepines ending at any time within the preceding weeks, as it may bring on withdrawal symptoms, including agitation, anxiety, emotional instability, as well as mild confusion and sensory distortions. Resurge is not recommended either as a treatment for benzodiazepine dependence or for managing prolonged benzodiazepine withdrawal syndromes. Resurge should be used with caution for reversing conscious sedation in children below the age of one year, for managing overdose in children, for resuscitating newborns, and for reversing the sedative effects of benzodiazepines used to induce general anaesthesia in children, since experience in these situations is limited.
নিষেধাজ্ঞা
Flumazenil should not be used in anyone known to be hypersensitive to it. It is also not given to reverse a benzodiazepine that was being used to control a potentially life-threatening condition, such as raised pressure within the skull or status epilepticus.