Abstract:

This report describes a case of alprazolam overdose associated with marked first-degree atrioventricular block reversed by flumazenil.

Animal and human evidence suggests activity of certain benzodiazepines at peripheral benzodiazepine receptors in the myocardium and elsewhere. Myocardial benzodiazepine receptor ligands appear to affect calcium-channel activity, which may explain the clinical findings. Benzodiazepines may behave like weak calcium-channel blockers.

This case raises the possibility of a potential role for flumazenil as an adjunct in the management of calcium-channel blocker toxicity.

Document Type: Research article

DOI: 10.1211/0022357991772385

Affiliations: 1: Oregon Poison Center, Department of Emergency Medicine, Oregon Health Sciences University, Portland, Oregan, USA