PAEA Surgery End Of Rotation (EOR) Practice Exam

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Which agent is the reversing agent for benzodiazepines?

Diphenhydramine
Flumazenil
Naloxone
Fentanyl

The correct answer is: Flumazenil

Flumazenil is the specific benzodiazepine antagonist used to reverse the effects of benzodiazepine overdoses or sedation. As a competitive antagonist at the GABA-A receptor, it displaces benzodiazepines that are bound to these receptors, effectively reversing their sedative and anxiolytic effects. This makes flumazenil particularly useful in clinical settings where rapid recovery from benzodiazepine-related sedation is required, such as in procedural sedation or in cases of overdose. Other agents listed do not have the same mechanism or indication. Diphenhydramine is an antihistamine that can have sedating properties but does not reverse benzodiazepine effects. Naloxone is an opioid antagonist and is used primarily for opioid overdoses rather than benzodiazepines. Fentanyl is an opioid analgesic and does not reverse the effects of benzodiazepines; rather, it would contribute to respiratory depression when used in conjunction with benzodiazepines. Thus, flumazenil uniquely serves the purpose of reversing benzodiazepine sedation.