This is a case on Benzodiazepine poisoning

1. Presented by :
B.Sunil Kumar Nayak

2. Patient Name : XYZ
Age : 25 Yrs
Sex :Male
Unit : Acute Medical Care Unit

3.  Complaints of giddiness and drowsiness since morning,
vomiting 4 episodes
 Administered 15 tablets of Rivotril (Clonazepam)
Gastric lavage was done with 2 liters of
Normal Saline solution in a local Hospital and came to
XYZ Hospital in view of drowsiness.

4.  MEDICAL HISTORY :- Insomnia & Headache
 MEDICATION HISTORY :- Clonazepam 0.5 mg
 FAMILY HISTORY :-Nothing significant
 SOCIAL HISTORY :-Nothing significant

5. S - Subjective Evidence
O - Objective Evidence
A - Assessment
P - Planning

6.  PROVISIONAL DIAGNOSIS:-
Benzodiazepine overdose….?

7. Intentional consumption of 15 tablets of
Clonazepam 0.5mg
All the lab parameters are normal.
FINAL DIAGNOSIS:-
BENZODIAZEPINE POISONING

8.  To neutralize the drug in the body
 To relieve from the drowsiness and giddiness
 To prevent from the severe complications
like hypotension and respiratory depression

9. S.I
NO
DRUGS
(Generic names)
DOSE ROA FRE DA DS
1 N.S 2 pint IV - 1 3
2 D.N.S 2 pint IV - 1 3
3 Inj.Ceftriaxone 1g IV BD 1 3
4 Inj.Pantoprazole 40mg IV OD 1 3
5 Tab.Flumazenil ( In case of respiratory
depression)
0.1mg PO SOS 1 3
6 Inj.25% Dextrose (in case of GRBS
<100mg/dl)

10. DAYS PROGRESS
DAY
-1
O/E:Patient is drowsy & responding to verbal commands,
PR:110bpm, BP:120/70mmhg, Spo2: 100% at RT, Pupils:
Reactive to light
LAB DATA
Blood Urea: 25mg/dl, Sr.Creatinine:0.8mg/dl, R.B.S:84mg/dl,
GRBS:120mg/dl
Dengue, Widal, Malaria test, HCV, HBsAG :- Negative
Platelets:2.33l/cumm,R.B.C:5.5mill/cumm,W.B.C:10.4kcells/c.m,
Hb:16g/dl, E.S.R: 15mm/1hr
N-89%, L-01%, M-02%, E-01%, B-00%
DAY-2  O/E: Patient is c/c
PR:78/min, BP:90/60mmhg, SPO2:100%, RS:BAE+,
Pupils:Reactive to light
GRBS: 83 mg/dl

11. DAYS PROGRESS
DAY-3 O/E:Patient is c/c.
PR:63/min, BP:100/60mmhg, RR:20/min, CVS:s1s2+
Beck’s suicidal content scale – Severe suicidal intent

12.  Drowsiness of the patient was decreased.
 No severe effects associated with the
poisoning were reported.

13.  To monitor the vitals like blood pressure, pulse rate,
respiratory rate etc.
 Monitor the airway, breathing, and circulation.

14. No problems were identified.

15.  Discharge medications:
1.Tab.Sertraline
25mg-OD-PO
2. Tab.Nervon forte
1 tab-PO-OD
Review after 7 days

16. 1.About Disease
2.About Medication
3.About life style modifications