Drug Profile
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| Generic Name | Diphenhydramine HCl
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| Brand Name | Benadryl
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| Class | antihistamine; anticholinergic
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| 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)
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| Indications and Field Use | Anaphylaxis (2nd line) Phenothiazine reactions (extrapyramidal symptoms) Antiemetic
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| Contraindications 1 of 4 | Known hypersensitivity to diphenhydramine or drugs of similar chemical structure.
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| Contraindications 2 of 4 | Newborn or premature infants; nursing mothers.
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| Contraindications 3 of 4 | Considerable caution in patients with glaucoma, acute narrow angle; stenosing or obstructive diseases of the GI tract;
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| Contraindications 4 of 4 | bronchial asthma; hyperthyroidism; cardiovascular disease or hypertension; age greater than 60 years (all relative benefit vs risk).
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| Adverse Reactions 1 of 5 | CV; Hypotension; palpitations; arrhythmias; hemolytic anemia.
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| Adverse Reactions 2 of 5 | Resp; Anaphylaxis; thickening of bronchial secretions, tightness in chest; wheezing; nasal stuffiness.
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| Adverse Reactions 3 of 5 | CNS; Sedation; visual disturbances; seizures
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| Adverse Reactions 4 of 5 | GU/GI; Urinary frequency or retention; vomiting.
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| Adverse Reactions 5 of 5 | Children; In children, may cause paradoxical CNS excitation, seizures, palpitations, thickening of bronchial secretions.
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| Adult Dosage 1 of 2 | Anaphylaxis; 25-50 mg slow IV push or deep IM.
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| 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.
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| Pediatric Dosage | 1.0 -1.25 mg/kg slow IV push; may also be given deep IM
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| 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.
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