Key messages

• Benzodiazepines are the drugs most frequently involved in acute poisoning.

• Benzodiazepine overdose usually has a good prognosis:

most patients do well with only careful observation and prevention of complications;

supportive care including intubation, ventilation, and fluid administration may be required in some cases.

• Care should be taken with the following:

• elderly people, patients with chronic obstructive pulmonary disease, or liver disease;

• short-acting compounds;

• association with other central nervous system depressants.

• Flumazenil is a useful diagnostic tool and may help to improve alertness and prevent the need for respiratory support in some patients. Introduction

Benzodiazepines have a wide pharmacological profile (namely hypnosedative, anxiolytic, muscle relaxant, amnestic, and anticonvulsant properties) and a high therapeutic index. They have replaced most older hypnosedatives, particularly barbiturates, in clinical use. Abuse potential has been recognized more recently.

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