🔄 Opioid / Benzodiazepine Antagonists

When to use

Reverse opioid or benzodiazepine effects when indicated; supportive care (airway/ventilation) is often the safer choice.

How it works

Naloxone 0.04–0.4 mg IV titrated q2–3min. Flumazenil 0.2 mg IV → 0.1–0.2 mg q1min, usually max ~1 mg.

Key points

• Naloxone precipitates withdrawal in dependence — titrate from a small dose.
• Flumazenil is not for diagnostic use in undifferentiated coma.
• Avoid flumazenil with seizure risk, TCA co-ingestion or QRS > 100 ms.
• Both antagonists are shorter-acting than the parent drug — watch for re-depression/re-sedation.

References

• AHA ACLS and toxicology references on antagonist use

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