Antidotes& Reversal
Reversal agent for benzodiazepines.
flumazenil
Short-term treatment for insomnia, mainly trouble falling asleep.
Zolpidem
NSAIDs commonly cause this GI complication.
What is GI bleeding/ulcer?
With zolpidem, patients should avoid this activity after taking it.
driving/operating machinery
Combining opioids with this class greatly increases sedation and respiratory depression.
benzodiazepines
Reverses opioid-induced respiratory depression.
naloxone
Urinary tract analgesic used to relieve dysuria symptoms (not an antibiotic).
Phenazopyridine
NSAIDs can worsen this organ’s function, especially with dehydration or older adults.
kidney function (renal injury)
This OTC sleep aid can worsen confusion and falls in older adults due to anticholinergic effects.
diphenhydramine
SSRI + other serotonergic meds increases risk for this complication.
serotonin syndrome
After giving this antidote, you may need repeat doses because it can wear off before the drug it reverses.
nalaxone
PTSD-related nightmares; also lowers blood pressure.
prazosin
Opioids can cause this dangerous effect that is the main cause of death in overdose.
respiratory depression
Phenazopyridine causes this harmless but alarming side effect that patients must be warned about.
orange-red urine
NSAIDs + anticoagulants/antiplatelets increases risk for this complication.
bleeding (especially GI bleeding)
This reversal agent can precipitate withdrawal and seizures in certain high-risk patients.
flumazenil
Opioid used for severe pain and also commonly used in anesthesia and acute care; very potent.
SSRI-related toxidrome with agitation, sweating, diarrhea, tremor, fever, and hyperreflexia/clonus.
serotonin syndrome
For prazosin, teach how to reduce the risk of first-dose fainting.
change positions slowly / take at bedtime
This TCA side-effect cluster is classic: dry mouth, urinary retention, constipation, blurred vision, confusion.
anticholinergic effects
Priority action when reversing opioid overdose: don’t skip this life-saving step before/while giving the antidote.
What is support airway/ventilation (bag-mask/O2)
Antidepressant often used at lower doses for sleep because of its sedating effect.
trazodone
TCA overdose is feared because it can rapidly cause this life-threatening problem.
fatal dysrhythmias/arrhythmias (cardiotoxicity)?
With acetaminophen, the “don’t miss” teaching is to avoid exceeding this safety issue.
max daily dose / liver toxicity risk
This beta blocker issue is a classic teaching point for diabetics.
masking hypoglycemia symptoms