A 32-year-old female took several lorazepam tablets; slight decreased LOC; rapid eye movements; Pupils 3 millimeters. What is the most appropriate management?

• A. Assist ventilation
• B. Administer naloxone
• C. Administer oxygen
• D. Administer flumazenil

Answer: (C)

In a benzodiazepine overdose, the priority is ensuring adequate breathing and oxygenation while you monitor for any progression to respiratory depression. This patient has slight decreased level of consciousness, so giving supplemental oxygen helps prevent hypoxia and buys time while you assess further from a safe position. The presence of normal to mildly constricted pupils makes opioid overdose unlikely, so naloxone isn’t indicated here. Flumazenil can reverse benzodiazepine effects but carries risks (seizures, withdrawal, especially in chronic users or mixed overdoses) and is generally not used unless in a controlled setting with clear indication. If breathing becomes depressed or the patient cannot protect their airway, you would escalate to assisted ventilation, but starting with oxygen is the most appropriate initial management in this scenario.