What is the reversal agent for benzodiazepines?

• A. Naloxone
• B. Flumazenil (Romazicon)
• C. Protamine
• D. Physostigmine

Answer: (B)

Flumazenil (Romazicon) is the reversal agent for benzodiazepines. It works by competitively blocking the benzodiazepine binding site on the GABA-A receptor, which stops the benzodiazepines from enhancing GABA’s calming effect. This rapidly reverses sedation and respiratory depression caused by benzodiazepines.

Keep in mind that reversing benzos can trigger withdrawal seizures in people who are benzodiazepine-dependent or who have mixed drug overdoses, so airway and seizure risk must be monitored. Also, flumazenil’s effect is shorter than many long-acting benzos, so symptoms can recur and additional dosing may be needed. It won’t reverse effects from opioids, so other agents are used for opioid overdoses.

The other agents listed reverse different problems: naloxone targets opioid receptors, protamine reverses heparin, and physostigmine treats anticholinergic toxicity.