We present the case of a 30-year-old woman presenting with seizures, a wide complex tachycardia, and cardiovascular collapse after an ingestion of diphenhydramine refractory to other therapies with rapid improvement after IFE administration. [ncbi.nlm.nih.gov]

• Fever

  Phenylephrine: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; chest pain; decreased coordination; difficulty urinating; fast or irregular heartbeat; fever [web.archive.org]

  Bottles Get relief from hay fever and seasonal allergies! Mini tablets are easy to swallow, yet pack a punch against allergies with 25 mg of the antihistamine Diphenhydramine Hydrochloride. [dollartree.com]

  INDICATIONS Benadryl® Allergy (diphenhydramine) Uses temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: runny nose sneezing itchy, watery eyes itching of the nose or throat temporarily relieves these symptoms due [rxlist.com]

  ULTRATABS^® Tablets with Allergy Relief and Diphenhydramine HCI 25mg Where to Buy Product Description Use BENADRYL® Allergy ULTRATABS® Tablets with 25 mg of diphenhydramine HCI, antihistamine, for effective relief from symptoms related to hay fever [benadryl.com]

  ₹ 100/ Pack Get Latest Price Minimum Order Quantity 100 Pack Diphenhydramine is an antihistamine used to relieve symptoms of allergy, hay fever, and the common cold. [indiamart.com]

• Swelling

  convulsions; decreased alertness; excitability; fast heartbeat; hallucinations; pain, redness, or swelling at the injection site; tightness or pounding in the chest; tremor; wheezing. [web.archive.org]

  Angioedema, or severe swelling, is a rare side effect of ACEIs and, to a lesser extent, a side effect of ARBs. The release of proteins that promote fluid accumulation and swelling are thought to contribute to angioedema. [livestrong.com]

  […] symptoms occur fever gets worse or lasts more than 3 days pain, cough or nasal congestion gets worse or lasts more than 5 days (children) or 7 days (adults) sore throat lasts for more than 2 days, is accompanied or followed by fever, headache, rash, swelling [rxlist.com]

• Intravenous Administration

  A rare occurrence of DPH abuse via documented intravenous administration leading to death is presented. [ncbi.nlm.nih.gov]

  After intravenous administration of 0.8 mg/kg diphenhydramine, a prolonged half-life was noted in patients with chronic liver disease which correlated with the severity of the disease 16. [drugbank.ca]

• Chills

  Top Diphenhydramine Injection The most frequent adverse reactions are underscored: General: Urticaria, drug rash, anaphylactic shock, photosensitivity, excessive perspiration, chills, dryness of mouth, nose, and throat. [web.archive.org]

  […] mouth Frequency not reported : Gastrointestinal disturbance, nausea, vomiting, constipation, diarrhea, dyspepsia, epigastric distress [ Ref ] Other Common (1% to 10%): Fatigue Frequency not reported : Lassitude, tinnitus, acute labyrinthitis, asthenia, chills [drugs.com]

  Photo Credit Dolly Faibyshev for The New York Times Work Out and Chill? Cool temperature workouts may be the answer for those who want to exercise without becoming a hot mess. [nytimes.com]

• Unconsciousness

  He was found unconscious and hypotensive. His serum potassium concentration was 8.3 mEq/L and the ECG revealed a coved-type ST-segment elevation in leads V2-V3. [ncbi.nlm.nih.gov]

  Use gastric lavage if patient is unconscious or ipecac fails. Treat hypotension with vasopressors and control seizures with diazepam or phenytoin. Don’t give stimulants. [glowm.com]

  If you've taken more than the usual dose you may: feel very sleepy feel sick (nauseous) get blurry eyesight feel your heart beating very fast In serious cases you can become unconscious and may need emergency treatment in hospital. [nhs.uk]

  Hypotension, manifest as dizziness, shock and unconsciousness or both, occurs in only 10 to 30% of individuals with anaphylaxis ( Brown 2001 ; Brown 2004a ; Kemp 2002 ; Lieberman 2003 ; Simons 2002 ). [doi.org]

• Dyspnea

  [ Ref ] Hepatic Rare (0.01% to 0.1%): Liver dysfunction [ Ref ] Dermatologic Frequency not reported : Rash, urticaria, skin rashes, erythema, photosensitivity, pruritus, drug rash, excessive perspiration [ Ref ] Respiratory Frequency not reported : Dyspnea [drugs.com]

• Vomiting

  GI System:Epigastric distress, anorexia, nausea, vomiting, diarrhea, constipation. GU System: Urinary frequency, difficult urination, urinary retention, early menses. [web.archive.org]

  View/Print Figure Etiology of Nausea and Vomiting FIGURE 1. Physiologic mechanisms that result in nausea and vomiting. Etiology of Nausea and Vomiting FIGURE 1. Physiologic mechanisms that result in nausea and vomiting. [aafp.org]

  H1-receptor antagonist H 1 -receptor antagonists are the drugs that selectively bind to but do not activate histamine H 1 receptors, thereby blocking the actions of endogenous histamine. antiemetic A drug used to prevent nausea or vomiting. [ebi.ac.uk]

  Our study showed that the new HG protocol was associated with a greater improvement of vomiting symptoms (36% vs. 21%; p=0.0397), and with fewer adverse events. [ncbi.nlm.nih.gov]

• Dyspepsia

  […] impairment, activation of epileptogenic foci [ Ref ] Drowsiness usually diminishes after a few days. [ Ref ] Gastrointestinal Common (1% to 10%): Dry mouth Frequency not reported : Gastrointestinal disturbance, nausea, vomiting, constipation, diarrhea, dyspepsia [drugs.com]

  […] not known irritability / Delayed / Incidence not known agitation / Early / Incidence not known diarrhea / Early / Incidence not known nausea / Early / Incidence not known anorexia / Delayed / Incidence not known vomiting / Early / Incidence not known dyspepsia [pdr.net]

• Abdominal Pain

  Make sure your physician is aware you are taking this medicine if you have symptoms of appendicitis such as stomach or lower abdominal pain, cramping, or soreness. [lyberty.com]

• Tachycardia

  Diphenhydramine toxicity commonly manifests with antimuscarinic features, including dry mucous membranes, tachycardia, urinary retention, mydriasis, tachycardia, and encephalopathy. [ncbi.nlm.nih.gov]

• Chest Pain

  convulsions; decreased alertness; excitability; fast heartbeat; hallucinations; pain, redness, or swelling at the injection site; tightness or pounding in the chest; tremor; wheezing. [web.archive.org]

  chest pain, shortness of breath, uneven heartbeats, seizure). [uwhealth.org]

  Benadryl may cause serious side effects including: pounding heartbeats or fluttering in your chest, painful or difficult urination, little or no urination, confusion, lightheadedness, tightness in your neck or jaw, and uncontrollable movements of your [rxlist.com]

• Xerostomia

  While xerostomia can be a mild aggravation for the patient and may not appear to be clinically relevant, chronic xerostomia can increase the risk for dental caries as well as worsen symptoms of gastroesophageal reflux disease (GERD). [ebmconsult.com]

  Interactions Found Interactions Found Serious - Use Alternative Significant - Monitor Closely All Interactions Sort By: Adverse Effects Frequency Not Defined Sedation Confusion Anticholinergic effects May decrease cognitive function in geriatric patients Xerostomia [reference.medscape.com]

  Incidence not known hypotension / Rapid / Incidence not known palpitations / Early / Incidence not known Mild drowsiness / Early / 22.1-22.1 restlessness / Early / 1.0-10.0 asthenia / Delayed / 4.4-4.4 headache / Early / 2.5-2.5 dizziness / Early / 2.5-2.5 xerostomia [pdr.net]

• Blurred Vision

  Nervous System: Sedation, sleepiness, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesia, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis [web.archive.org]

  vision, dry eyes, diplopia [ Ref ] Metabolic Frequency not reported : Increased appetite, anorexia [ Ref ] Musculoskeletal Frequency not reported : Muscle twitching /weakness [ Ref ] References 1. [drugs.com]

• Flushing

  Examination revealed 4-mm reactive pupils; nystagmus; warm, dry, flushed skin; and altered mental status. [ncbi.nlm.nih.gov]

  Symptoms Agitation Blurred vision Coma Confusion Convulsions Delirium Diarrhea Drowsiness Dry cotton-like mouth Flushing on the face and skin Inability to urinate Incoherence (not understandable) Lack of sweat Low grade fever Movement problems Nausea [web.archive.org]

  Additional symptoms during overdose may include mydriasis, fever, flushing, agitation, tremor, dystonic reactions, hallucinations and ECG changes 13. [drugbank.ca]

• Pruritus

  Definition (MSH) A histamine H1 antagonist used as an antiemetic, antitussive, for dermatoses and pruritus, for hypersensitivity reactions, as a hypnotic, an antiparkinson, and as an ingredient in common cold preparations. [fpnotebook.com]

  CASE SUMMARY: A 56-year-old white man was receiving diphenhydramine 300 mg/d for 2 days to treat pruritus caused by a bullous rash possibly induced by vancomycin. [ncbi.nlm.nih.gov]

  […] muscarinic cholinergic receptors, thereby blocking the actions of endogenous acetylcholine or exogenous agonists. antiparkinson drug A drug used in the treatment of Parkinson's disease. antipruritic drug A drug, usually applied topically, that relieves pruritus [ebi.ac.uk]

  0.1%): Hypersensitivity reactions Frequency not reported : Angioedema, anaphylactic shock [ Ref ] Hepatic Rare (0.01% to 0.1%): Liver dysfunction [ Ref ] Dermatologic Frequency not reported : Rash, urticaria, skin rashes, erythema, photosensitivity, pruritus [drugs.com]

• Dermatitis

  Patients who develop contact dermatitis from it should avoid its oral or parenteral administration because they may develop a localized or generalized flare of dermatitis. [ncbi.nlm.nih.gov]

  Brandão and An Goossens, Topical Drugs, Contact Dermatitis, 10.1007/978-3-642-03827-3_38, (729-762), (2010). [doi.org]

  Diphenhydramine, synthetic drug used in the treatment of various conditions including hay fever, acute skin reactions (such as hives ), contact dermatitis (such as from poison ivy ), and motion sickness. [britannica.com]

• Skin Rash

  urticaria, skin rashes, erythema, photosensitivity, pruritus, drug rash, excessive perspiration [ Ref ] Respiratory Frequency not reported : Dyspnea, thickening of bronchial secretions, throat tightening, wheezing, nasal stuffiness, dry nose or throat [drugs.com]

  Diphenhydramine is used to treat sneezing, runny nose, watery eyes, hives, skin rash, itching, and other cold or allergy symptoms. [uwhealth.org]

• Insect Bite

  Definition (NCI_NCI-GLOSS) A drug used to treat allergies and relieve cough and itching caused by insect bites, sunburn, and poison oak or ivy. [fpnotebook.com]

  Additional information about Difenidramina Difenidramina Indication: For the treatment of symptoms associated with Vertigo /Meniere's disease, nausea and vomiting, motion sickness and insect bite. [minclinic.ru]

  Dosage for insect bites, stings and eczema Diphenhydramine comes as a cream which you use once or twice a day. You'll only need a small amount, enough for a thin layer. [nhs.uk]

  This results in effects such as the reduction of smooth muscle contraction, making diphenhydramine a popular choice for treatment of the symptoms of allergic rhinitis, hives, motion sickness, and insect bites and stings. [worldofmolecules.com]

  As an OTC medication, diphenhydramine is typically formulated as tablets and creams indicated for use in treating sneezing, runny nose, itchy/watery eyes, itching of nose or throat, insomnia, pruritis, urticaria, insect bites/stings, allergic rashes, [drugbank.ca]

• Dysuria

  […] perspiration [ Ref ] Respiratory Frequency not reported : Dyspnea, thickening of bronchial secretions, throat tightening, wheezing, nasal stuffiness, dry nose or throat [ Ref ] Genitourinary Frequency not reported : Urinary hesitancy/difficulty/retention, dysuria [drugs.com]

  Urogenital: Urinary frequency or retention, dysuria. Body as a Whole: Hypersensitivity (skin rash, urticaria, photosensitivity, anaphylactic shock ). Respiratory: Thickened bronchial secretions, wheezing, sensation of chest tightness. [robholland.com]

  GU: dysuria, urine retention, urinary frequency. Hematologic: hemolytic anemia, thrombocytopenia, agranulocytosis. Respiratory: nasal congestion, thickening of bronchial secretions. Skin: urticaria, photosensitivity, rash. Other: anaphylaxis. [glowm.com]

  Adverse Effects Common Adverse Effects Drowsiness Dizziness Impaired coordination Headache Epigastric discomfort Thickened bronchial secretions Dry mucous membranes CNS stimulation, paradoxical Constipation Euphoria Ataxia Dysuria Urinary retention Hypotension [ncbi.nlm.nih.gov]

• Confusion

  Diphenhydramine/Ibuprofen: Severe allergic reactions (rash; hives; itching; trouble breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); bloody or black, tarry stools; change in the amount of urine produced; chest pain; confusion [web.archive.org]

  […] infants, diphenhydramine in over-dosage may cause convulsions or death May cause significant sedation or paradoxical excitation/akethesia Diphenhydramine has additive effects with alcohol and other CNS depressants Antihistamines may cause dizziness, confusion [orangecountyfl.net]

  Older adults may be more sensitive to the side effects of this drug, especially drowsiness, dizziness, confusion, constipation, or trouble urinating. Drowsiness, dizziness, and confusion can increase the risk of falling. [webmd.com]

  ] Other Common (1% to 10%): Fatigue Frequency not reported : Lassitude, tinnitus, acute labyrinthitis, asthenia, chills, impaired performance (including impaired driving, work, and/or information processing) [ Ref ] Psychiatric Rare (0.01% to 0.1%): Confusion [drugs.com]

• Seizure

  The generalized seizures continued for duration of 30 min, despite the intravenous administration of 8 mg of lorazepam. The patient underwent endotracheal intubation and a propofol infusion terminated her seizures. [ncbi.nlm.nih.gov]

  […] reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); blurred vision; chest pain; decreased coordination; difficulty urinating; fast or irregular heartbeat; fever; hallucinations; seizure [web.archive.org]

  Midazolam was administered with seizure resolution. Examination revealed 4-mm reactive pupils; nystagmus; warm, dry, flushed skin; and altered mental status. [doi.org]

• Tremor

  […] lips, or tongue); blurred vision; chest pain; decreased coordination; difficulty urinating; fast or irregular heartbeat; fever; hallucinations; seizure; severe dizziness or drowsiness; severe nervousness, anxiety, restlessness, or trouble sleeping; tremors [web.archive.org]

  We report the case of 1 patient with congestive heart failure (CHF) and PD who was unable to swallow and developed uncontrollable tremors 24 hours prior to death and whose tremors were successfully treated with diphenhydramine. [ncbi.nlm.nih.gov]

  As a side effect, these drugs may cause tremors and abnormal involuntary movements of the muscles, referred to as extrapyramidal neurologic movement disorders. Diphenhydramine is used to control these symptoms. [encyclopedia.com]

• Vertigo

  RESULTS: The strength of vertigo can be reduced by the application of diphenhydramine. [ncbi.nlm.nih.gov]

  In addition to the usual allergic symptoms, the drug also treats irritant cough and nausea, vomiting, and vertigo associated with motion sickness. [minclinic.ru]

  Nervous System: Sedation, sleepiness, dizziness, disturbed coordination, fatigue, confusion, restlessness, excitation, nervousness, tremor, irritability, insomnia, euphoria, paresthesia, blurred vision, diplopia, vertigo, tinnitus, acute labyrinthitis [web.archive.org]

  […] diphenhydramine [ di″fen-hi´drah-mēn ] an antihistamine with anticholinergic effects; the hydrochloride salt is used for relief of allergic symptoms, for treatment of anaphylaxis, parkinsonism, and motion sickness or other causes of nausea, vomiting, or vertigo [medical-dictionary.thefreedictionary.com]

  Common (1% to 10%): Sedation/somnolence/sleepiness, drowsiness, unsteadiness, dizziness, headache, attention disturbance Rare (0.01% to 0.1%): Extrapyramidal effects, tremor, convulsions Frequency not reported : Paresthesia, dyskinesia/muscle dyskinesia, vertigo [drugs.com]

• Agitation

  We cared for a 46-year-old patient who became extremely agitated after receiving a dose of intravenous diphenhydramine. [ncbi.nlm.nih.gov]

  […] asthenia, chills, impaired performance (including impaired driving, work, and/or information processing) [ Ref ] Psychiatric Rare (0.01% to 0.1%): Confusion, depression, sleep disturbances Frequency not reported : Paradoxical excitation/excitation, agitation [drugs.com]

  Symptoms Agitation Blurred vision Coma Confusion Convulsions Delirium Diarrhea Drowsiness Dry cotton-like mouth Flushing on the face and skin Inability to urinate Incoherence (not understandable) Lack of sweat Low grade fever Movement problems Nausea [web.archive.org]

  BLADDER AND KIDNEYS Inability to urinate EYES, EARS, NOSE, MOUTH, AND THROAT Blurred vision Dry mouth Enlarged pupils Very dry eyes Ringing in the ears HEART AND BLOOD VESSELS Low blood pressure Rapid heartbeat NERVOUS SYSTEM Agitation Confusion Seizures [nlm.nih.gov]

Further workup revealed urinary diphenhydramine levels suggesting drug overdose. This case serves as a reminder of the oxytocin-like effects of diphenhydramine. [ncbi.nlm.nih.gov]

[…] depression Head CT scan, in patients with seizures or altered mental status ECG, especially if tachycardia or bradycardia is present Lumbar puncture, if patient has altered mental status or new-onset seizures in the setting of an unknown toxic exposure See Workup [emedicine.medscape.com]

Consider treatment alternatives when possible. Loratadine may be considered as an alternative for the treatment of allergy symptoms. [pdr.net]

After treatment with sodium bicarbonate failed to improve cardiac status, the patient underwent emergency charcoal hemoperfusion and hemodialysis with rapid improvement in the ECG findings within the first 40 minutes of treatment and with no further need [ncbi.nlm.nih.gov]

The patient may receive: Activated charcoal Breathing support Fluids through a vein (by IV) Tube through the mouth into the stomach to wash out the stomach ( gastric lavage ) Outlook (Prognosis) Recovery is likely if the patient survives the first 24 [web.archive.org]

Fluids through a vein (by IV) Medicines to treat symptoms or reverse the effects of the overdose Activated charcoal Laxative Breathing support, including a tube through the mouth into the lungs and connected to a breathing machine (ventilator) Outlook (Prognosis [mountsinai.org]

Prognosis The prognosis is affected by the presence of underlying medical conditions, co-ingestions, and the amount of drug ingested. The vast majority of patients recover with supportive care and observation. [emedicine.medscape.com]

Fetal tachycardia is attributable to a variety of etiologies, including an untreated maternal medical condition or an indicator of potential fetal compromise. Maternal medication administration may also affect the fetal heart rate. [ncbi.nlm.nih.gov]

View/Print Figure Etiology of Nausea and Vomiting FIGURE 1. Physiologic mechanisms that result in nausea and vomiting. Etiology of Nausea and Vomiting FIGURE 1. Physiologic mechanisms that result in nausea and vomiting. [aafp.org]

Etiology The 3 main components of most cough and cold medicines, and the source of toxicity from them, are antihistamines, decongestants, and antitussives. Allergy medications typically contain antihistamines, decongestants, or both. [emedicine.medscape.com]

On the other hand, alcohol provokes food-induced histaminosis and histamine intolerance, which is an epidemiological problem. [doi.org]

Furthermore, no study has shown a benefit in the management of these conditions with either antihistamines or decongestants. [53] Epidemiology The AAPCC reported that in the United States in 2014, cough and cold preparations accounted for 60,300 total [emedicine.medscape.com]

Epidemiology of cough. Pulm Pharmacol Ther. 2002 ; 15 : 253 – 259 ↵ Gruber CM, Carter CH. A measure of the effectiveness of propoxyphene antitussives in children. Am J Med Sci. 1961 ; 242 : 443 – 446 ↵ Carter CH. [pediatrics.aappublications.org]

Patient Information Handout An understanding of the pathophysiology of nausea and the mechanisms of antiemetics can help family physicians improve the cost-effectiveness and efficacy of therapy. [aafp.org]

This mechanistic distinction is seldom used now, as it is recognized that the clinical picture and the treatment of anaphylaxis are similar regardless of trigger factor or pathophysiologic mechanisms ( Kemp 2002 ; Lieberman 2003 ). [doi.org]

Pathophysiology The principal active ingredients in cough and cold medications are antihistamines, decongestants, and antitussives. Allergy medications typically contain antihistamines, decongestants, or both. [emedicine.medscape.com]

This prevents histamine-induced bronchoconstriction, vasodilation, increased capillary permeability, and GI smooth muscle spasms. [fpnotebook.com]

PURPOSE: In this study the potential of diphenhydramine in reducing respectively preventing vertigo and nausea induced by the ultra-high static magnetic field at 7 T was evaluated. [ncbi.nlm.nih.gov]

Antihistamines prevent the physiological actions of histamine by preventing histamines from reaching H1- and H2-receptor sites. Antihistamines provide short-lived benefits and provide only symptomatic relief. [eilat.sci.brooklyn.cuny.edu]