The document discusses the mechanisms, signs, symptoms, diagnosis, and antidotes for benzodiazepines and opioids toxicity. Benzodiazepines can cause CNS depression with symptoms like lethargy and respiratory depression, while opioids lead to sedation and respiratory issues. Antidotes include flumazenil for benzodiazepines and naloxone for opioids, each with specific safety considerations.

1. TOXICITY FOR
• BENZODIAZEPINES
• OPIOIDS
EDITED
BY MR MOMPATI LETSWELETSE
(CPhT) SECOND YEAR STUDENT

2. BENZODIAZEPINES
MECHANISM OF TOXICITY
Benzodiazepines bind to a specific receptors on
the Gamma-aminobutyric acid(GABA)
receptors complex augmenting(increasing) the
actions of GABA,which increases permeability
of chloride resulting in reduced neuronal
excitability

3. Signs and symptoms
Onset of CNS depression
Lethargy(a lack of energy and enthusiasm)
Slurred speech(Dysarthria)
Ataxia(the loss of full control of bodily movements.)
 coma
Respiratory depression
Decreased libido & erection problem are common
Amnesia (the loss of memories)

4. DIAGNOSIS
• Obtain an arterial blood gas (ABG) if respiratory
depression is present
• Obtain an ECG to evaluate for co-ingestants,
particularly cyclic antidepressants
• Obtain a chest radiograph if respiratory
compromise is present
• In patients with an intentional overdose, measure
the following:
• Serum electrolytes ,Glucose ,BUN, Cretinine
clearance, Ethanol, Acetaminophen level

5. ANTIDOTE: Flumazenil,
• Flumazenil, a specific benzodiazepine
antagonist It reverses the effects of BZD by
competitive inhibition at the BZD binding site
on the GABAA receptor.
• Patients should be monitored for resedation,
respiratory depression or other persistent or
recurrent agonist effects for an adequate
period of time after administration of
flumazenil.

6. SAFETY PROFILE
• Flumazenil is contraindicated when the
patients ingested multiple medicine
• Flumazenil should be used with caution with
patients with a history of seizures,head injury
or chronic benzodiazepines use

7. OPIODS:MECHANISM OF TOXICITY
• opioids have the ability to stimulate a number
of specific opiate receptors in the CNS, causing
sedation and respiratory depression.

8. SIGNS AND SYMPTOMS
• Respiration depression leading to hypoxia
• Hypotension
• Delayed motility of the GI tract,in particular
manifesting as delayed gastric emptying
• Nausea and vomiting due to effects of oipiods
on the chemotherapy receptor trigger zone
• coma is accompanied by respiratory
depression

9. DIAGONOSIS
• White blood and urine samples may be taken
to confirm opioid ingestion
• Electrolytes
• Glucose
• arterial blood
• gases or oximetry,
• chest x-ray,

10. ANTIDOTE:NALOXONE
• MOA: Naloxone is pure opioid antagonists
that competitively block μ,κ, and σ opiate
receptors within the central nervous system.

11. SAFETY PROFILE
• It is not used for the acute reversal of opioid
intoxication
• is not effective orally but may be given
subcutaneously, intramuscularly,
intravenously, or even endotracheally