ABSTRACT
This chapter summarizes the approach to the diagnosis and treatment of toxic ingestions of barbiturate and nonbarbiturate sedative-hypnotic agents. Flumazenil also reverses the central nervous system (CNS) depression observed in ethanol intoxication, but has no effect in either barbiturate or tricyclic antidepressant overdose. Flumazenil and related compounds appear very promising in reversing the CNS depressant effects of benzodiazepines and may reflect the future approach to the treatment of serious benzodiazepine intoxication. In patients receiving chronic therapy, the administration of specific benzodiazepine antagonists such as flumazenil may also give rise to this syndrome of drug withdrawal. Drug overdose, either accidental or intentional, continues to account for a significant proportion of emergency room visits and hospitalizations each year. By nature of their legitimate and illegitimate use, pharmacologic agents, such as barbiturates, benzodiazepines, and other nonbarbiturate sedative-hypnotics, persist in being implicated in many poisonings each year worldwide.
