22
Treatment
Table 2. Medications for Managing Intoxication
a
Agent/Class Mechanism Example dosing
Sedatives
Benzodiazepines
(BZDs) (first line)
GABAergic Initial dosing :
Lorazepam 1–2 mg intravenous (IV)
based on clinical signs and symptoms
and duration of effects
Diazepam 5–10 mg per os (by mouth/
oral) (PO) for less severe symptoms
based on patient parameters
Midazolam 5 mg intramuscular (IM)
or 0.01–0.05 mg/kg IV for acute
agitation in adult patients
Redosing frequency and dose should
be guided by the degree and duration
of the clinical effects of the initial dose
Phenobarbital
(PBO)
GABAergic Incremental 130–260 mg IM/IV/
PO based on symptoms and patient
parameters
Loading strateg y (eg, 5–10 mg/kg )
Titrate based on clinical effects
Propofol GABAergic + N-methyl-
D-aspartate (NMDA)
receptor antagonism
10–50 μg/kg/min based on symptoms
and patient parameters
Sympatholytics
Clonidine Alpha-2 agonism +/–
other
0.1–0.2 mg PO every 4 hours as
needed
Dexmedetomidine Alpha-2 agonism Start at 0.2–0.4 μg/kg/hr and titrate
every 30 min up to maximum of 1.5
μg/kg/hr
