19-year-old Joffrey L. is brought to the emergency room unconscious with a respiratory rate of only 6 (this is very low). His new roommate reports that Joffrey is otherwise totally healthy but says he saw Joffrey taking some medicine earlier. He hands over the bottle of medicine he saw Joffrey use and you see it is a alprazolam (Xanax), a benzodiazepine used commonly for certain anxiety disorders. Dr. Snow arrives, glances at the bottle and then elbows you aside. He administers an IV dose of the benzodiazepine antagonist flumazenil. Joffrey begins to have convulsions. A. Explain in detail the mechanism by which the benzodiazepine antagonist flumazenil can potentially cause a seizure in a patient with no prior history of epilepsy.
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