How to neutralize the effect of phenazepam

The tranquilizer "Phenazepam" is a potent sedative. When using it, under no circumstances should you exceed the recommended number of tablets. Otherwise, you can get severe intoxication. In toxicological and drug addiction practice, poisoning with this tranquilizer is often observed. In such cases, the antidote Phenazepam is used. It neutralizes the sedative effect of the tablets. What kind of drug is this and how to use it? We will consider these questions in the article.

Description of the tranquilizer

"Phenazepam" is a tranquilizer from the group of benzodiazepines. This is a pretty powerful drug. In terms of the strength of its effect on the body, it surpasses many other similar drugs.

The active component of the tranquilizer (phenazepam) binds to special benzodiazepine receptors in the body. This promotes better absorption of chlorine ions by nerve cells and a decrease in neuron excitability.

A person’s anxiety and irritability disappear, and mental calm occurs. Sleep becomes deep and sound. In addition, the drug relaxes muscles and eliminates cramps.

Indications and contraindications

The drug "Phenazepam" is prescribed for the following pathologies:

• neuroses;
• insomnia;
• anxiety disorders;
• hypochondria;
• epilepsy;
• panic attacks;
• neurocirculatory dystonia;
• withdrawal syndrome in alcoholism and drug addiction;
• in preparation for operations.

This medicine should not be prescribed for lung diseases. It depresses respiratory function. The drug is also contraindicated in pregnant women and patients with myasthenia gravis.

A tranquilizer is never prescribed for a long period of time. Benzodiazepine drugs are often painfully addictive. Therefore, people prone to drug dependence are not recommended to take this drug.

Many patients experience lethargy and drowsiness in the first days of tranquilizer treatment. With an overdose, these side effects increase many times over.

Contraindications to the use of Phenazepam

Taking the drug is not indicated for everyone. You should avoid using the medicine:

1. In case of hypersensitivity to the active component or additional components of the drug, as well as to other drugs included in the benzodiazepine group.
2. In acute attacks of angle-closure glaucoma or predisposition to the development of the disease. Taking the drug can cause complete loss of vision. And this process will become irreversible.
3. With the development of myasthenia gravis. A feature of this neuromuscular disease is rapid fatigue of skeletal muscles.
4. In case of acute poisoning with alcoholic drinks, sleeping pills or narcotic drugs.
5. Pregnant women, especially in the early stages. The active component penetrates the placenta, causing a toxic effect on the fetus. This can cause severe birth defects. Nursing mothers should also refuse to take it.

The drug is not prescribed to patients in a state of shock and coma. Its use is not recommended for people suffering from severe depression with suicidal tendencies.

Phenazepam is not prescribed to children and adolescents under 18 years of age.

The drug is prescribed to patients only on the recommendation of a doctor and under his supervision:

1. With renal or liver failure.
2. With acute psychosis.
3. With ataxia. The pathology is characterized by a violation of the coordination of movements of different muscle groups in the absence of muscle weakness.
4. With sensory impairment or motor function disorders.
5. Low protein in the blood.
6. In the presence of tumor processes in the brain.
7. Having a tendency to drug addiction.
8. Suffering from apnea syndrome.

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The drug causes a decrease in concentration and slows down reactions, so its use is prohibited for people whose activities involve driving a car or other complex mechanisms.

Causes of poisoning

On average, tranquilizer doses from 0.5 to 5 mg are used to treat neuropsychic pathologies. In severe cases, it is allowed to take 10 mg of medication per day. However, this dose is taken in several doses.

Acute poisoning occurs if a person takes more than 10 mg of this medicine at a time. When taking about 1 g of the drug, death occurs.

What are the causes of an overdose of Phenazepam tablets? Typically, patients exceed the permissible amount of medication in the following cases:

1. With tolerance to the drug. Over time, the body adapts to the tranquilizer. The previous number of tablets ceases to have the desired effect. The patient increases the dose of the drug, and as a result, poisoning occurs.
2. In the formation of mental and physical dependence. Long-term use of the drug can lead to addiction. An unhealthy addiction to the drug is formed. In order to achieve maximum sedative effect, a person begins to take more and more Phenazepam tablets.
3. With withdrawal syndrome. Abrupt cessation of taking a tranquilizer leads to a deterioration in health. For this reason, doctors recommend gradually reducing the dose of the drug. Drug withdrawal syndrome is accompanied by unpleasant sensations: fatigue, weakness, insomnia, anxiety, and decreased mood. To get rid of such symptoms, patients often take excessive amounts of pills.
4. When taking alcohol together. Tranquilizers and alcohol are absolutely incompatible. Ethanol potentiates the effect of the tablets, which can lead to respiratory and cardiac depression. Even therapeutic doses of the drug can become dangerous if the patient allows himself to drink alcohol during treatment.
5. When attempting suicide. Psychiatrists prescribe this medicine with caution for severe depression. The drug may increase suicidal tendencies in such patients.

Often, small children are accidentally poisoned with tranquilizers. Therefore, the packaging with the drug should be kept in a place inaccessible to the child.

It is important to remember that an overdose can occur not only with a single dose of a large number of tablets. If a person for a long time even slightly exceeds the permissible dose of the drug, chronic intoxication may occur.

Signs of overdose

Symptoms and signs of Phenazepam overdose depend on the number of tablets taken, as well as on alcohol consumption during therapy.

In case of mild overdose, the following manifestations are observed:

• drowsiness and desire to lie down;
• asthenia;
• lethargy;
• deterioration of memory and performance.

Such phenomena can be chronic if a person constantly violates the recommended treatment regimen.

Moderate intoxication is accompanied by the following symptoms:

• clouding of consciousness;
• severe drowsiness;
• deep sleep with difficulty waking up;
• dyspeptic symptoms (nausea, vomiting, constipation or diarrhea);
• increased secretion of saliva;
• cardiac arrhythmia;
• a sharp decrease in blood pressure;
• severe lethargy;
• difficulty breathing;
• urinary disorders.

In case of severe overdose, the patient experiences dangerous symptoms:

• loss of consciousness (up to the development of coma);
• weak breathing;
• rare heartbeat;
• increased muscle tone;
• cramps of the arms and legs;
• pulmonary edema.

In case of severe overdose, patient survival depends on the timeliness of care. If treatment is delayed, the person may die from respiratory depression.

Phenazepam poisoning in children

Despite the strict prohibition, there are cases of use of phenazepam by children. This usually occurs when a person taking this drug lives in the home. Phenazepam should be stored strictly out of the reach of children.

The causes of poisoning can be different: a child found the drug and drank it without permission, adults confused phenazepam with another drug and accidentally gave it to a child, adults deliberately gave the drug to a child without knowing the consequences.

Symptoms of poisoning may be as follows:

• Nausea, vomiting;
• Depression of consciousness, up to stupor and coma;
• Hallucinations, agitation, delusions;
• Impaired breathing and heartbeat, even to the point of stopping respiratory and cardiac activity.

For children under 10 years of age, a dose of less than 5 mg can be fatal; in older patients, death is possible with consumption of about 10 mg.

First aid

What to do in case of an overdose of Phenazepam? An ambulance must be called immediately. Before the doctors arrive, the following measures must be taken:

1. If the person is conscious, then gastric lavage should be done. It is necessary to dissolve 2 - 3 teaspoons of salt in 1 liter of clean water and give it to the patient to drink. You then need to press on the back of the patient's tongue to induce vomiting. However, this measure helps only in the first 2 hours after taking an excess amount of tablets.
2. Then the patient is given an enterosorbent: Polysorb, activated carbon or Smecta. This will help reduce the effect of the tranquilizer on the body.
3. If the patient has lost consciousness, then he needs to be turned on his side. A person should remain in this position until doctors arrive. This will help prevent the tongue from sinking and vomit from entering the respiratory system.

Further treatment of a patient with an overdose of Phenazepam is carried out in a hospital setting. The course of therapy usually takes from 14 to 90 days. Its duration depends on the severity of intoxication.

In the hospital, the patient is given the antidote Phenazepam. This is the drug "Flumazenil". Next we will look at this medicine in more detail.

What to do if you develop an overdose of Phenazepam

It is necessary to call an ambulance and take the victim to the hospital. Before the doctors arrive, you can try to help the person yourself. If you do not provide him with help in the first few hours, then this threatens the development of serious complications.

Gastric lavage

If the patient is conscious, then to quickly remove the remaining drug, he needs to rinse his stomach.

• To carry out the procedure, you should drink 1 liter of clean water at room temperature or a hypertonic salt solution.
• To prepare it, you need to dissolve 2-3 tbsp in water. l. table salt. It is not recommended to use a manganese solution, so as not to cause a burn to the esophageal mucosa.
• Then you should induce vomiting by placing 2 fingers in your mouth and pressing on the root of the tongue. To cleanse the stomach as much as possible, you need to repeat the procedure several times.

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Sorbents

Drugs in this group are used to neutralize the effect of Phenazepam and cleanse the intestines of harmful substances. Products that need to be mixed with water have the fastest action. However, if there are none, then you can use the products in tablet form.

After cleansing, it is necessary to restore the intestinal microflora. The use of Bifiform or other products containing bifidobacteria will help with this.

Drink plenty of fluids

If you are poisoned, you should drink as much fluid as possible. You can give the victim tea or just water. Since Phenazepam poisoning can cause problems with swallowing function, you need to ensure that you drink slowly and in small sips.

What to do if a person is unconscious

If the patient has lost consciousness, you need to quickly lay him down on a flat surface. Raise your legs up slightly to increase blood flow to the heart and head. Turn your head to the side. This will prevent vomit from entering your respiratory tract if vomiting begins.

While waiting for an ambulance, you need to constantly monitor the patient's breathing and pulse.

If these signs are absent, then clinical death occurs. In this situation, resuscitation measures should be performed: perform indirect cardiac massage, perform artificial respiration.

You can check breathing by placing your hand on the patient's chest. It is easier to monitor your pulse by placing your hand on the carotid artery in your neck. This is a large vessel that is easy to detect even for an inexperienced person.

Health care

The patient is given an antidote that can block benzodiazepine receptors. Thanks to this, the hypnotic and sedative effects of Phenazepam are neutralized.

Treatment in hospital

In a hospital setting, the victim is provided with qualified medical care: the stomach is washed, then a substance is administered that helps stop the activity of Phenazepam.

When drawing up a scheme for further therapy, the causes of poisoning and the general condition of the patient are taken into account. If necessary, additional tests are prescribed.

In case of severe poisoning, an antidote is administered intravenously. Prescribed medications that support the functioning of the cardiovascular and respiratory systems.

When should an antidote not be administered?

There are cases when the administration of the antidote "Phenazepam" is contraindicated. Flumazenil is not used if the patient is taking tranquilizers for epilepsy or high intracranial pressure. Otherwise, blocking benzodiazepine receptors can lead to seizures or severe cerebral hypertension.

Combined poisoning with Phenazepam and tricyclic antidepressants (for example, Amitriptyline) often occurs. In this case, it is also impossible to administer an antidote; this may worsen the patient’s condition.

How to treat overdose in such cases? The patient is given forced diuresis to remove the tranquilizer metabolites through the kidneys. The patient is given a drip with the diuretic drug Furosemide. In mild cases, a diuretic is prescribed orally.

How to administer the antidote

Flumazenil is available in powder form. It is intended for intravenous administration. In case of poisoning, 0.3 mg of the drug is diluted in saline and the patient is given a drip. If necessary, the dosage is increased, carefully monitoring the patient's condition.

Is it possible to administer an antidote at home before the ambulance arrives? Doctors do not recommend doing this. It is not always the case that the person providing first aid is fluent in the technique of intravenous injections. Inept administration of the drug can cause harm to the victim.

In addition, it is not always possible to establish what exactly the patient was poisoned with, especially if the person is unconscious. Flumazenil has contraindications that only a doctor can take into account. Therefore, using the Phenazepam antidote at home is extremely undesirable. It can only be administered in a hospital under the supervision of a specialist.

Other drugs

As already mentioned, Flumazenil is the only benzodiazepine receptor blocker. Other drugs are prescribed only for symptomatic treatment of overdose. They are not antidotes for tranquilizers. Let's look at these tools in more detail:

1. "Mesocarb". This remedy is a strong psychostimulant. It helps reduce the unwanted effects of tranquilizers. This drug is prescribed to correct residual effects of overdose (lethargy, asthenia, drowsiness). However, if taken for a long time, this drug can cause serious dependence.
2. Analeptics (“Cordiamin”, “Caffeine”, “Bemegrid”). These drugs stimulate breathing and heart muscle function. They are administered to maintain vital body functions.
3. Emetic drugs (Digoxin, Apomorphine, Emetine). Such drugs are effective only in the first hours after an overdose. They provoke the gag reflex and remove toxins from the stomach.

Restoration of the body

What consequences from an overdose of Phenazepam may occur in the distant future? The body recovers from poisoning quite slowly. Patients often experience the following residual effects for a long time:

• movement coordination disorders;
• dizziness;
• asthenia;
• emotional lability;
• depression;
• asthenia;
• dysfunction of the liver and kidneys.

All this indicates that Phenazepam is a difficult drug. For this reason, it is released from pharmacies strictly by prescription. When taking it, you must be very careful and adhere to the recommended treatment regimen.

Phenazepam is the first Soviet benzodiazepine tranquilizer, a popular drug with a sedative and hypnotic effect. Phenazepam is prescribed for increased anxiety, neuroses, hypochondriacal syndrome, and also to relieve symptoms of alcohol poisoning. The price and prevalence of Phenazepam in pharmacies contributes to the popularity of the drug.

Possibility of prescribing for children

Children's age is one of the contraindications to the use of phenazepam. As a rule, when treating a small patient, you can get by with lighter analogues. Tranquilizers approved for use by persons under 18 years of age include:

• Diazepam (can be taken by babies older than 1 month);
• Gidazepam;
• Elenium (patients over 6 years old);
• Oxazepam (patients over 6 years of age).

All of the listed medications belong to the group of benzodiazepines and are available with a doctor’s prescription. In addition, it is important to strictly adhere to the dosage, which depends on the age, body weight of the child (up to a year) and the reason for prescribing the medicine.

The main reason that phenazepam cannot be used by persons under 18 years of age is that there is no data on its safety and effectiveness in this group of patients.

There is currently no such remedy as children's phenazepam.

How does Phenazepam poisoning occur?

Phenazepam is used in the treatment of alcohol poisoning. If therapy takes place not in a clinic, but at home, the influence of a harmful environment can provoke the use of Phenazepam along with alcohol. This combination has extremely adverse consequences for the body.

Symptoms of Phenazepam poisoning

Phenazepam poisoning is accompanied by the following symptoms:

• depression of cardiac activity;
• breathing problems;
• increased salivation;
• excessive production of sputum in the lungs.

Other manifestations of poisoning depend on the amount of Phenazepam taken, the time elapsed from the moment of administration, and the individual characteristics of the body. There are three stages of Phenazepam poisoning.

First stage of poisoning

Mild poisoning with Phenazepam can be recognized by the following signs:

• clouding of consciousness;
• drowsiness;
• a state close to drug intoxication;
• hearing impairment.

Poisoning is accompanied by dysfunction of the visual muscles. The following manifestations are possible:

• convergence - simultaneous movement of the eyes in opposite directions;
• ptosis – drooping of the upper eyelid;
• nysgam – involuntary movements of the eyeballs of high frequency.

Second stage of poisoning

Phenazepam poisoning of moderate severity is manifested by the following symptoms:

• constriction of the pupils;
• suppression of the cough reflex;
• difficulty swallowing;
• deterioration of tendon and corneal reflexes.

At this stage, a superficial coma is possible.

Third stage of poisoning

Severe poisoning with Phenazepam is expressed by the following manifestations:

• complete absence of reflexes;
• agony;
• pathological dilation of the pupils;
• drop in blood pressure;
• tachycardia;
• hypothermia;
• deep coma.

Chronic poisoning with Phenazepam systematically exceeds the prescribed dosage. Poisoning leads to frequent migraines, convulsions, hallucinations, and increased excitability. If urgent measures are not taken, death is possible.

Overdose, addiction, harm to the body

For outpatient treatment (at home), Phenazepam is taken 0.25–0.5 mg 2–3 times a day. Under the supervision of a doctor in a hospital, the dosage can be increased to 5–10 mg per day. Such measures are taken for effect as a last resort - for example, in the treatment of epilepsy.

• excessive sleepiness;
• prolonged confusion;
• decreased reflexes;
• long-term dysarthria;
• muscle tremors;
• bradycardia (low heart rate, pulse about 30–50 beats per minute);
• shortness of breath, disruption of the respiratory cycle;
• decreased blood pressure;
• coma.

Taking Phenazepam, even in permitted doses, may be accompanied by side effects:

• regular feeling of fatigue;
• deterioration of concentration, attention and memory;
• partial or complete disorientation;
• difficulty in motor and mental reactions;
• headaches;
• increased depression;
• asthenic syndrome;
• dysarthria (speech disorder);
• dizziness;
• ataxia (motility disorder, expressed in inconsistency of movements of different muscle groups);
• unbalanced gait;
• confusion;
• euphoric state.

Disturbances in the functioning of the cardiovascular system and changes in the biochemical composition of the blood are often observed. Long-term use of Phenazepam can provoke:

• leukopenia and agronulocytosis - a decrease in the level of leukocytes in the blood;
• thrombocytopenia – decreased platelet count, deterioration of coagulation;
• neutropenia – a decrease in the number of neutrophils, reducing the body’s resistance to bacteria and fungi;
• tachycardia – increased heart rate;
• anemia – decreased levels of hemoglobin and red blood cells.

Lethal dosage

Overdose of Phenazepam and death are rare in medical practice. This combination is possible when taking a lethal dosage and/or combining the medication with large volumes of strong alcohol.

The occurrence of death due to an overdose of Phenazepam depends on several factors. This is the general condition of the patient, the presence of chronic pathologies, drug dependence, alcohol abuse and smoking.

In accordance with the instructions, the maximum permissible daily dosage of the medication is 10 mg. Exceeding this volume leads to the development of overdose symptoms. Lethal outcome occurs with consumption of 0.5 mg per kilogram of weight. In children, death from Phenazepam occurs when taking 0.25 mg per kilogram of body weight.

First aid for poisoning

In case of poisoning with Phenazepam, you must immediately call a doctor. While waiting for the medical team, you should take a number of actions on your own. First aid for Phenazepam poisoning includes the following measures:

1. Gastric lavage. If the patient is conscious, you need to force him to drink several glasses of water and forcefully induce vomiting. The procedure is repeated several times to remove the maximum amount of the drug from the body. It is advisable to infuse the liquid in a sitting position, since a violation of the swallowing reflex is often observed. If the patient is unconscious, these measures are permissible only after intubation of the upper respiratory tract, otherwise you may suffocate.
2. Purgation. The victim is given a saline laxative, and also given an enema based on herbal decoctions or plain water - whatever is on hand.
3. Taking enterosorbents. Any products with a sorbing effect are suitable - activated carbon, Polysorb, Enterosgel. They will help prevent the drug from entering the blood and remove some of the dangerous substances.
4. Symptomatic therapy. It is necessary to monitor the patient’s blood pressure and breathing and provide all possible assistance. If a person loses consciousness, they are placed in a horizontal position and their legs are elevated, providing increased blood flow to the heart and brain. The head should be tilted to the side to prevent the patient from choking on vomit. The tongue needs to stick out; you can fix it in this position by wrapping it with a bandage around a tablespoon.

In a hospital setting, doctors, in addition to similar actions, administer Flumazenil to the patient. This Phenazepam antidote is not used at home due to the need to take into account many factors - the general condition of the victim, the functionality of the cardiovascular system, and the nature of breathing. In severe cases of poisoning, hemosorption or hemodialysis are also prescribed, but their effectiveness is low. If respiratory function is impaired, artificial ventilation is performed.

Anexat is used as an alternative antidote. Add 0.2 mg of the drug to a saline-based dropper and control the duration of the procedure. After half a minute, 3–5 mg of solution enters the blood. If the risk of epileptic seizures is high, the use of Anexat is not advisable.

The volume of Phenazepam in the blood is determined using a laboratory test of blood serum using the spectrophotometric method. Additionally, an electrocardiogram and a test for acidosis are prescribed.

Lethal dose of Phenazepam

The lethal dosage of Phenazepam depends on the patient's body weight. For an adult, this figure is 0.5 mg per 1 kg of weight; for children - half as much. Other factors also influence:

• the patient's mental state;
• combination with alcohol, and the amount of alcohol taken;
• work of the cardiovascular system;
• condition of the liver and kidneys;
• presence of chronic diseases;
• duration of treatment and degree of patient addiction.

Phenazepam is quickly absorbed from the stomach and absorbed by the body. The maximum concentration of Phenazepam in the blood is achieved 1-2 hours after ingestion. The half-life of elimination from the body takes from 6 to 18 hours, depending on the individual characteristics of the body.

Phenazepam poisoning in children

To avoid poisoning a child with Phenazepam, the drug should be stored in a place inaccessible to children. For patients under 18 years of age, this tranquilizer can only be prescribed by a doctor, and only if there are serious reasons. Statistics show that the most common causes of poisoning of children with Phenazepam include:

• accidentally taking medication intended for a family member;
• curiosity and desire to experiment;
• deliberate attempt at suicide.

Most often, poisoning occurs in children aged 0 to 3 years (6 out of 10 reported cases). Symptoms of central nervous system dysfunction, stunning, and hallucinations predominate.

At the same time, adolescents suffer the consequences of poisoning more severely than young children. At the age of 12–14 years, the body is characterized by instability of heart rhythm, so it is more difficult for it to cope with the effects of the drug.

Consequences of Phenazepam poisoning

The drug is a potent substance. If there is a doctor's prescription, incorrect use and overdose of Phenazepam are not uncommon. The consequences of self-medication and poisoning can be very serious, including respiratory arrest and death.

The recovery period after Phenazepam poisoning takes a long time. The victim may still have impaired coordination of movements, functional disorders of the kidneys and liver. Often there is a depressive state caused by withdrawal syndrome. During the period of Phenazepam poisoning, the patient must be under the supervision of medical specialists, otherwise repeated incidents are possible.

Phenazepam is the first domestic highly active tranquilizer from the group of benzodiazelines.

By acting on the central nervous system and cerebral cortex, it eliminates nervous tension, relieves anxiety and fear, relaxes muscles and has a hypnotic effect. Careless use can cause dependence on Phenazepam.

What is the lethal dose of Phenazepam

The amount of the drug that can lead to death depends on a number of factors, including the general condition of the patient, the presence of chronic pathologies, and the fact of addiction. The fact of drinking alcohol and smoking also matters. This medicine and strong drinks are incompatible.

The instructions for the drug state that the maximum permissible daily dose is 10 mg. Exceeding this value can lead to undesirable consequences: severe poisoning can occur, which can provoke severe complications, including death.

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For adult patients, the dose at which you can die is taking 0.5 mg of the drug per 1 kg of body weight. For children – 0.25 mg/1 kg.