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Lu X, Wu Z, Wang M, Cheng W

8.2 Summary of RCTs Early studies using low-dose NAC (200 mg TID) showed no significant benefit over placebo in PEFR, weight, antibiotic use, cough, sputum viscosity, or symptom perception (102)

Differential diagnosis of coma or sedation of unknown origin (to check if benzodiazepine involvement exists) --- Dosage (Adults): Initial dose: 0.2 mg IV over 15 seconds If no response, give 0.3 mg after 30 seconds May repeat 0.5 mg every 30 seconds up to a total of 3 mg (occasionally 5 mg if needed) --- Side Effects: Nausea and vomiting Dizziness Agitation or anxiety Headache Seizures (especially in patients dependent on benzodiazepines or co-ingesting tricyclic antidepressants) Arrhythmias (rare) --- Contraindications: Hypersensitivity to flumazenil Chronic benzodiazepine users (can trigger withdrawal and seizures) Patients with seizure disorders treated with benzodiazepines Mixed drug overdose (especially tricyclic antidepressants) --- Precautions: Continuous monitoring required for respiration and consciousness Risk of re-sedation after initial reversal due to flumazenils short half-life Use cautiously in hepatic impairment --- Storage: Store below 25C, protected from light

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