Management of Overdose: Manifestations of a Valium overdose
include somnolence, confusion, coma, and diminished reflexes. Respiration, pulse,
and blood pressure should be monitored, as in all cases of suspected drug overdose.
General supportive measures should be employed, along with immediate gastric
lavage. Intravenous fluids should be administered and an adequate airway maintained.
Hypotension may be combated by the use of levarterenol or metaraminol. Dialysis
is of limited value. As with the management of intentional overdose with any
drug, it should be borne in mind that multiple agents may have been ingested.
Flumazenil, a specific benzodiazepine-receptor antagonist, is indicated for
the complete or partial reversal of the sedative effects of benzodiazepines
such as Valium and may be used in situations when an overdose with benzodiazepine
is known or suspected. Prior to the administration of flumazenil, necessary
measures should be instituted to secure airway, ventilation, and intravenous
access. Flumazenil is intended as an adjunct to, not as a substitute for,
proper management of benzodiazepine overdose. Patients treated with flumazenil
should be monitored for re-sedation, respiratory depression, and other residual
benzodiazepine effects for an appropriate period after treatment.
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