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Diphenhydramine

Drug Profile

QuestionAnswer
Generic Name Diphenhydramine HCl
Brand Name Benadryl
Class antihistamine; anticholinergic
Mechanism of Action Blocks cellular histamine receptors, but does not prevent histamine release; results in decreased capillary permeability and decreased vasodilation, as well as prevention of bronchospasm. Has some anticholinergic effects. (1 pt)
Indications and Field Use Anaphylaxis (2nd line) Phenothiazine reactions (extrapyramidal symptoms) Antiemetic
Contraindications 1 of 4 Known hypersensitivity to diphenhydramine or drugs of similar chemical structure.
Contraindications 2 of 4 Newborn or premature infants; nursing mothers.
Contraindications 3 of 4 Considerable caution in patients with glaucoma, acute narrow angle; stenosing or obstructive diseases of the GI tract;
Contraindications 4 of 4 bronchial asthma; hyperthyroidism; cardiovascular disease or hypertension; age greater than 60 years (all relative benefit vs risk).
Adverse Reactions 1 of 5 CV; Hypotension; palpitations; arrhythmias; hemolytic anemia.
Adverse Reactions 2 of 5 Resp; Anaphylaxis; thickening of bronchial secretions, tightness in chest; wheezing; nasal stuffiness.
Adverse Reactions 3 of 5 CNS; Sedation; visual disturbances; seizures
Adverse Reactions 4 of 5 GU/GI; Urinary frequency or retention; vomiting.
Adverse Reactions 5 of 5 Children; In children, may cause paradoxical CNS excitation, seizures, palpitations, thickening of bronchial secretions.
Adult Dosage 1 of 2 Anaphylaxis; 25-50 mg slow IV push or deep IM.
Adult Dosage 2 of 2 Extrapyramidal symptoms and antiemetic; 10-50 mg IV or deep IM, dose individualized according to the needs and patient response.
Pediatric Dosage 1.0 -1.25 mg/kg slow IV push; may also be given deep IM
Bonus Points Not used in newborn or premature infants; used in pregnancy only if clearly needed. In anaphylaxis, used as a 2nd line treatment after epinephrine and steroids.
Created by: firemedic911