Why the study?
Does flumazenil reverse first-degree atrioventricular block in alprazolam overdose?
Does flumazenil reverse first-degree atrioventricular block in alprazolam overdose?
Flumazenil can reverse first-degree AV block caused by alprazolam overdose, suggesting a potential adjunctive role in managing calcium-channel blocker toxicity.
May suggest flumazenil utility in alprazolam-induced AV block; hypothesis-generating and should not yet change practice.
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.
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Michael E. Mullins (1999) studied this question.
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