Drug class | Reversal agent | Dose of reversal agent (IV) | Time between repeat doses | Maximum cumulative initial dose | Additional dosing if necessary |
Opioids | Naloxone | 40 mcg | 2 to 5 minutes | 10 mcg/kg | Infusion at 1 to 10 mcg/kg per hour, with careful titration of the infusion rate according to patient response. |
Benzodiazepine | Flumazenil | 0.2 mg | 1 minute | 1 mg | After a 20 minute interval, if sedation is evident, additional 0.2 mg doses may be administered to a maximum of 1 mg. After another 20 minute interval, this dosing may be repeated. No more than 3 mg should be administered in a single hour. |
Anticholinergic agent | Physostigmine | 0.5 to 1 mg (slow IV push) | 5 to 10 minutes | 2 mg |
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