LighthouseTM Medical Emergency Medication:
Guidelines have been established to help doctors and staff members adequately prepare for the immediate and effective management of life-threatening situations.
With HANSAmed being the sole provider and distributor of LIGHTHOUSETM across Canada, we have developed different solutions to accommodate all dental clinical medical emergency needs.
Flumazenil injection, USP is a benzodiazepine receptor antagonist. Flumazenil injection is indicated for the complete or partial reversal of the sedative effects of benzodiazepines in cases where general anesthesia has been induced and/or maintained with benzodiazepines, where sedation has been produced with benzodiazepines for diagnostic and therapeutic procedures, and for the management of benzodiazepine overdose.
Flumazenil injection is indicated for the reversal of conscious sedation induced with benzodiazepines.
Flumazenil injection is recommended for intravenous use only.
Reversal of conscious sedation & reversal of general anesthesia:
- For the reversal of the sedative effects of benzodiazepines administered for conscious sedation, the recommended initial dose of flumazenil injection is 0.2 mg administered intravenously over 15 seconds. If the desired level of consciousness is not obtained after waiting an additional 45 seconds, a second dose of 0.2 mg can be injected and repeated at 60-second intervals
Management of suspected benzodiazepine overdose in adult patients:
- For initial management of a known or suspected benzodiazepine overdose, the recommended initial dose of flumazenil injection is 0.2 mg administered intravenously over 30 seconds. If the desired level of consciousness is not obtained after waiting 30 seconds, a further dose of 0.3 mg can be administered over another 30 seconds. Further doses of 0.5 mg can be administered over 30 seconds at 1-minute intervals up to a cumulative dose of 3 mg.
Do not rush the administration of flumazenil injection. Patients should have a secure airway and intravenous access before administration of the drug and be awakened gradually.
The LIGHTHOUSETM medical emergency kit is a lifesaving investment and includes flumazenil in any LIGHTHOUSETM kit as an add-on product.
The use of flumazenil has been associated with the occurrence of seizures.
These are most frequent in patients who have been on benzodiazepines for long-term sedation or in overdose cases where patients are showing signs of serious cyclic antidepressant overdose.
Practitioners should individualize the dosage of flumazenil and be prepared to manage seizures.
Risk of Seizures:
- The reversal of benzodiazepine effects may be associated with the onset of seizures in certain high-risk populations. Possible risk factors for seizures include: concurrent major sedative-hypnotic drug withdrawal, recent therapy with repeated doses of parenteral benzodiazepines, myoclonic jerking or seizure activity prior to flumazenil administration in overdose cases, or concurrent cyclic antidepressant poisoning.
Return of Sedation:
- Flumazenil may be expected to improve the alertness of patients recovering from a procedure involving sedation or anesthesia with benzodiazepines, but should not be substituted for an adequate period of post-procedure monitoring. The availability of flumazenil does not reduce the risks associated with the use of large doses of benzodiazepines for sedation.
Patients should be monitored for resedation, respiratory depression or other persistent or recurrent agonist effects for an adequate period of time after administration of flumazenil.