Description

The premise of the coma cocktail is to give a group of treatments to a patient presenting with unexplained coma, often before assessing the patient. Such "shotgun" therapy may have a role in some situations, but it can result in added expense and risk of adverse reactions for no benefit to the patient.


 

A typical coma cocktail may consist of:

(1) dextrose for hypoglycemia

(2) thiamine for beri beri

(3) naloxone for opiate intoxication

(4) flumazenil for benzodiazepine intoxication

 

The main issue would be the routine administration of naloxone and flumazenil if there is no reason to suspect one of the target drugs.

 

Thiamine would be indicated for a patient with risk factors such as chronic alcohol abuse and with signs of Wernicke's encephalopathy. However, the risk of its use is low and risk factors may not be known.

 


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