Establish an IV and administer benzodiazepines to patients with severe agitation. If poor venous access or severe agitation preclude intravenous placement, consider using intramuscular lorazepam or midazolam. IV hydration and sedation are initial management considerations. Rule out hypoglycemia using a Dextrostix fingerstick glucose determination. Activated charcoal minimizes the enterohepatic circulation of the drug.
More specific therapy is case specific.
IV benzodiazepines with or without antipsychotics are the drugs of choice. Hyperthermia may be treated by external cooling methods. Seizures respond well to IV benzodiazepines. Phenobarbital or pentobarbital constitute adjunctive therapy. Hypertensive crises may require nitroprusside or other vasoactive substances.