The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform
Ijaz A. Khan - One of the best experts on this subject based on the ideXlab platform.
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Prolonged QT interval with markedly abnormal ventricular repolarization in Diphenhydramine overdose
International journal of cardiology, 2005Co-Authors: John Sype, Ijaz A. KhanAbstract:Diphenhydramine is a histamine-1 receptor antagonist of ethanolamine origin with anticholinergic, sedative, antivertigo, antiemetic, antidyskinetic, and local anesthetic properties. It inhibits the fast sodium channels and, at higher concentrations, also the potassium channels, inhibition of which may result in QT interval prolongation on electrocardiogram. The markedly abnormal ventricular repolarization is rare with Diphenhydramine overdose. We report a case where a young woman who took moderate overdose of Diphenhydramine (625 mg) along with acetaminophen developed prolonged QT interval with strikingly abnormal T waves. These changes reverted to normal with treatment. Patient did not experience torsade de pointes, possibly secondary to the protective effect of the Diphenhydramine overdose-related tachycardia. As the tachycardia caused by Diphenhydramine overdose seems to protect against torsade de pointes, it may be practical to avoid bradycardia in acute phase of Diphenhydramine toxicity. Acetaminophen has not been shown to prolong QT interval or effect cardiac repolarization.
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QT interval prolongation in Diphenhydramine toxicity.
International Journal of Cardiology, 2005Co-Authors: Abhash C. Thakur, Ahmad Kamal Aslam, Ahmed F. Aslam, Balendu C. Vasavada, Terrence J. Sacchi, Ijaz A. KhanAbstract:Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with Diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of Diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate Diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval.
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Letter to the Editor QT interval prolongation in Diphenhydramine toxicity
2005Co-Authors: Abhash C. Thakur, Ahmad Kamal Aslam, Ahmed F. Aslam, Balendu C. Vasavada, Terrence J. Sacchi, Ijaz A. KhanAbstract:Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with Diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of Diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate Diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval. D 2004 Elsevier Ireland Ltd. All rights reserved.
Jhi-joung Wang - One of the best experts on this subject based on the ideXlab platform.
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prophylactic Diphenhydramine attenuates postoperative catheter related bladder discomfort in patients undergoing gynecologic laparoscopic surgery a randomized double blind clinical study
Journal of Anesthesia, 2020Co-Authors: Yansyun Zeng, Jhi-joung Wang, Jenyin Chen, Kueifen Wang, Chunghsi Hsing, Pinghsun Feng, Chin-chen ChuAbstract:To evaluate the effectiveness of Diphenhydramine, an antihistamine with anti-muscarinic properties, for prevention of postoperative catheter-related bladder discomfort (CRBD). Ninety-six ASA physical status I and II adult female patients (20–60 years) scheduled for elective gynecologic laparoscopic surgery were included. Patients were randomized into two groups of 48 patients each. All patients received a detailed preoperative explanation of the possible consequences of CRBD. The control group received normal saline 2 ml, whereas the Diphenhydramine group received Diphenhydramine 30 mg intravenously after induction of general anesthesia. Then, all patients were catheterized with a 14F Foley catheter and the balloon was inflated with 10 ml of distilled water. All patients who complained of CRBD in the postoperative room were appeased with nursing. Ketorolac 30 mg was used as the rescue drug on patients’ request or when the patient was evaluated as having moderate or severe CRBD. Bladder discomfort and its severity were assessed at 1, 2 and 6 h postoperatively. The severity of CRBD was graded as none, mild, moderate and severe. Adverse effects of Diphenhydramine such as sedation, dry mouth or GI upset were recorded. The incidence of CRBD was lower in the Diphenhydramine group compared with the control group at 2 h (34.8 vs. 58.7%, p = 0.02) and 6 h (23.9 vs. 56.5%, p 0.05). Prophylactic Diphenhydramine 30 mg at induction of general anesthesia reduced the incidence and severity of postoperative bladder discomfort without significant side effects in patients receiving gynecologic laparoscopic surgery.
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Spinal anesthesia with Diphenhydramine and pheniramine in rats.
European Journal of Pharmacology, 2011Co-Authors: Ching Hsia Hung, Chin-chen Chu, Yu Chung Chen, Yu Wen Chen, Jhi-joung WangAbstract:Abstract The aim of this study was to evaluate the local anesthetic effects of pheniramine and Diphenhydramine, two histamine H 1 receptor antagonists, on spinal anesthesia and their comparison with lidocaine, a commonly used local anesthetic. After rats were injected intrathecally with Diphenhydramine and pheniramine, the dose–response curves were obtained. The potency and duration of Diphenhydramine and pheniramine on spinal anesthesia were compared with lidocaine. We showed that Diphenhydramine and pheniramine produced dose-dependent spinal blockades in motor function, proprioception, and nociception. On a 50% effective dose (ED 50 ) basis, the rank of potency of drugs was Diphenhydramine = pheniramine > lidocaine ( p 25 , ED 50 , and ED 75 ), the block duration caused by Diphenhydramine was longer than that caused by pheniramine or lidocaine ( p
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Spinal anesthesia with Diphenhydramine and pheniramine in rats.
European journal of pharmacology, 2011Co-Authors: Ching Hsia Hung, Chin-chen Chu, Yu Chung Chen, Yu Wen Chen, Jhi-joung WangAbstract:The aim of this study was to evaluate the local anesthetic effects of pheniramine and Diphenhydramine, two histamine H₁ receptor antagonists, on spinal anesthesia and their comparison with lidocaine, a commonly used local anesthetic. After rats were injected intrathecally with Diphenhydramine and pheniramine, the dose-response curves were obtained. The potency and duration of Diphenhydramine and pheniramine on spinal anesthesia were compared with lidocaine. We showed that Diphenhydramine and pheniramine produced dose-dependent spinal blockades in motor function, proprioception, and nociception. On a 50% effective dose (ED₅₀) basis, the rank of potency of drugs was Diphenhydramine=pheniramine>lidocaine (p
Ching Hsia Hung - One of the best experts on this subject based on the ideXlab platform.
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Spinal anesthesia with Diphenhydramine and pheniramine in rats.
European Journal of Pharmacology, 2011Co-Authors: Ching Hsia Hung, Chin-chen Chu, Yu Chung Chen, Yu Wen Chen, Jhi-joung WangAbstract:Abstract The aim of this study was to evaluate the local anesthetic effects of pheniramine and Diphenhydramine, two histamine H 1 receptor antagonists, on spinal anesthesia and their comparison with lidocaine, a commonly used local anesthetic. After rats were injected intrathecally with Diphenhydramine and pheniramine, the dose–response curves were obtained. The potency and duration of Diphenhydramine and pheniramine on spinal anesthesia were compared with lidocaine. We showed that Diphenhydramine and pheniramine produced dose-dependent spinal blockades in motor function, proprioception, and nociception. On a 50% effective dose (ED 50 ) basis, the rank of potency of drugs was Diphenhydramine = pheniramine > lidocaine ( p 25 , ED 50 , and ED 75 ), the block duration caused by Diphenhydramine was longer than that caused by pheniramine or lidocaine ( p
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Spinal anesthesia with Diphenhydramine and pheniramine in rats.
European journal of pharmacology, 2011Co-Authors: Ching Hsia Hung, Chin-chen Chu, Yu Chung Chen, Yu Wen Chen, Jhi-joung WangAbstract:The aim of this study was to evaluate the local anesthetic effects of pheniramine and Diphenhydramine, two histamine H₁ receptor antagonists, on spinal anesthesia and their comparison with lidocaine, a commonly used local anesthetic. After rats were injected intrathecally with Diphenhydramine and pheniramine, the dose-response curves were obtained. The potency and duration of Diphenhydramine and pheniramine on spinal anesthesia were compared with lidocaine. We showed that Diphenhydramine and pheniramine produced dose-dependent spinal blockades in motor function, proprioception, and nociception. On a 50% effective dose (ED₅₀) basis, the rank of potency of drugs was Diphenhydramine=pheniramine>lidocaine (p
Abhash C. Thakur - One of the best experts on this subject based on the ideXlab platform.
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QT interval prolongation in Diphenhydramine toxicity.
International Journal of Cardiology, 2005Co-Authors: Abhash C. Thakur, Ahmad Kamal Aslam, Ahmed F. Aslam, Balendu C. Vasavada, Terrence J. Sacchi, Ijaz A. KhanAbstract:Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with Diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of Diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate Diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval.
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Letter to the Editor QT interval prolongation in Diphenhydramine toxicity
2005Co-Authors: Abhash C. Thakur, Ahmad Kamal Aslam, Ahmed F. Aslam, Balendu C. Vasavada, Terrence J. Sacchi, Ijaz A. KhanAbstract:Diphenhydramine overdose in one of the frequent reported causes of acute poisoning. Patients with Diphenhydramine overdose can present with central nervous system manifestations, anticholinergic manifestations and cardiovascular symptoms. The cardiovascular symptoms of Diphenhydramine overdose include myocardial depression and refractory hypotension. Massive ingestions have been reported to cause myocardial depressant effect with widening of QRS complex and prolonged QT interval on electrocardiogram. We report an adolescent male with moderate Diphenhydramine ingestion, who was found unresponsive with seizure like activity. Electrocardiogram on presentation showed wide complex tachycardia with right bundle branch block pattern and QT interval prolongation. These changes reverted to normal with treatment. Diphenhydramine overdose may occasionally result in prolongation of QT interval. D 2004 Elsevier Ireland Ltd. All rights reserved.
Robert S. Hoffman - One of the best experts on this subject based on the ideXlab platform.
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status epilepticus and wide complex tachycardia secondary to Diphenhydramine overdose
Clinical Toxicology, 2010Co-Authors: David H Jang, Lewis S. Nelson, Alex F Manini, Nathan S Trueger, Danny Duque, Nestor B Nestor, Robert S. HoffmanAbstract:Objective. Diphenhydramine is an H1 histamine antagonist that is commonly used for allergic reactions, colds and cough, and as a sleep aid. In addition to anticholinergic and antihistaminergic effects, sodium channel blockade becomes evident following Diphenhydramine overdose. While seizures may occur following overdose of a Diphenhydramine, status epilepticus is distinctly uncommon. We report a case with both status epilepticus and wide-complex dysrhythmias following an intentional Diphenhydramine overdose. Case report. A 36-year-old woman with a medical history of hypothyroidism on levothyroxine was brought to the emergency department with active seizures by emergency medical services after what was later determined to be a Diphenhydramine overdose. One hour after an argument with her husband he found her lethargic in a locked room. Initial vital signs were: blood pressure, 90/55 mmHg; heart rate, 160 beats/min; respiratory rate 18 breaths/min; room air oxygen saturation, 99%; temperature, 99.8°F; rapid...
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Diphenhydramine-induced wide complex dysrhythmia responds to treatment with sodium bicarbonate.
The American journal of emergency medicine, 2003Co-Authors: Adhi N. Sharma, Aaron Hexdall, Elbert K Chang, Lewis S. Nelson, Robert S. HoffmanAbstract:Diphenhydramine, a common ingredient in over-the-counter medications, is often taken in overdose. Toxicity is usually limited to anticholinergic symptoms. However, because Diphenhydramine also exhibits type IA sodium channel blockade, cardiac toxicity is also possible. Although it would be expected that, like other type IA toxicities, Diphenhydramine-induced cardiotoxicity could be responsive to hypertonic sodium bicarbonate, this finding is largely unappreciated. We describe 3 cases of Diphenhydramine-induced cardiac toxicity that were responsive to bicarbonate.
