The Efficacy of Aminophylline on Raising Consciousness in Benzodiazepines-Intoxicated Patients

Abstract

Background: Loss of consciousness and respiratory failure are the most important medical problems in acute benzodiazepines (BZDs) toxicity. The possibility of respiratory apnea increases in intentional cases and also in the presence of underlying cardiopulmonary diseases. The inhibitory effect of aminophylline on adenosine receptor may be the cause of recovery of consciousness in patients intoxicated by BZDs. The effect of aminophylline as an agonist of cAMP (cyclic adenosine monophosphate), on reversal of inhibitory effects of BZDs (benzodiazepines) on the brain and increasing the level of consciousness is the main question. Method: we reviewed literature sources on topic of aminophylline and consciousness. 29 articles were compiled from prestigious scientific databases such as PubMed, Scopus and Elsevier, from 1983 to 2017. Results: This review showed that intravenous aminophylline can lead to clinical improvement of both consciousness and respiration via antagonizing sedation that induced by BZDs. Although administration of flumazenil is still the first choice for apnea related to BZDs overdose and it is also more potent than aminophylline on reversing sedation, aminophylline can be substituted when flumazenil is not available or when it has contraindication such as in epileptic patients and in overdoses with drugs capable of causing convulsion. Also, aminophylline is useful in those BZD-intoxicated patients with coincident underlying COPD and asthma. Conclusion: intravenous aminophylline could decrease the sedative effects of BZDs and also speed up the recovery of consciousness in patients under sedative effects of BZDs.