Benzodiazepine Reversal — MFDS Part 1 MCQ

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EasyPharmacologyBenzodiazepine ReversalMFDS Part 1

A patient receiving intravenous midazolam for conscious sedation during dental treatment develops excessive benzodiazepine-induced sedation. Which drug is the specific pharmacological antagonist used to reverse the central sedative effects of midazolam?

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Correct answer: B — Flumazenil

Flumazenil is the specific benzodiazepine-receptor antagonist and can reverse the central sedative effects of midazolam. Airway support, ventilation and monitoring remain essential; flumazenil is not a substitute for resuscitative measures or a routine component of conscious sedation. Its action may be shorter than that of the benzodiazepine, so resedation can occur. It must be used cautiously because abrupt reversal can precipitate withdrawal or convulsions, particularly after prolonged benzodiazepine exposure or mixed overdose. Naloxone reverses opioids, atropine treats clinically significant bradycardia and muscarinic toxicity, N-acetylcysteine is used for paracetamol poisoning, and protamine reverses unfractionated heparin.

Reference: hameln pharma ltd. Flumazenil 100 micrograms/ml solution for injection/infusion, Summary of Product Characteristics, sections 4.1, 4.4 and 5.1; text revised 2022, eMC updated 2023. https://www.medicines.org.uk/emc/product/6300/smpc