diphenhydramine overdose

dragonfly99 · Jul 13, 2013

has anyone else seen diphenhydramine overdose lately? I got asked to consult on a patient who had taken 30 pills of sleep aid, plus some alcohol. She did have sinus tachycardia but no arrhythmias at all. It was only 1 day since last drink so maybe early for EtOH withdrawal. She had been intubated the night before but by the time I saw her was fine except acting a little jittery and heart rate was 112-120 or so sinus tach. I looked it up and there does seem to be tachycardia as one of the side effects of diphenhydramine, but it's not something I see often (people who've taken too much diphenhydramine). Any thoughts?

Daiphon · Jul 14, 2013

dragonfly99 said:
has anyone else seen diphenhydramine overdose lately? I got asked to consult on a patient who had taken 30 pills of sleep aid, plus some alcohol. She did have sinus tachycardia but no arrhythmias at all. It was only 1 day since last drink so maybe early for EtOH withdrawal. She had been intubated the night before but by the time I saw her was fine except acting a little jittery and heart rate was 112-120 or so sinus tach. I looked it up and there does seem to be tachycardia as one of the side effects of diphenhydramine, but it's not something I see often (people who've taken too much diphenhydramine). Any thoughts?

Certainly fits with the anticholinergic effects... would be nice to know her pupillary & skin exams. Also, delayed GI motility can result in delayed or prolonged absorption/symptoms.

BTW, "1 day since her last drink" doesn't exclude withdrawal. It's a clinical dx based on symptoms & signs, not timing. If you're a professional drinker, and normally function at a BAC of 300 but metabolize down to 150 (numbers wholly made up), you can be in w/d despite still being legally intoxicated... if the shoe fits, yanno?

Cheers!
-d

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njac · Jul 28, 2013

No good diphenhydramine lately, but did get a nice jimson weed + meth the other day.

DPIC · Jul 30, 2013

I received another case of diphenhydramine over dose, it was by 3-year child who ingested around 8 tablets, came with fits, hyperthermia, sinus tachycardia, Gastric lavage was done and activated charcoal was given.. patient was admitted to the pediatric ward for 48 hours, after which he was improved and discharged.

J-Rad · Jul 30, 2013

dragonfly99 said:
has anyone else seen diphenhydramine overdose lately? I got asked to consult on a patient who had taken 30 pills of sleep aid, plus some alcohol. She did have sinus tachycardia but no arrhythmias at all. It was only 1 day since last drink so maybe early for EtOH withdrawal. She had been intubated the night before but by the time I saw her was fine except acting a little jittery and heart rate was 112-120 or so sinus tach. I looked it up and there does seem to be tachycardia as one of the side effects of diphenhydramine, but it's not something I see often (people who've taken too much diphenhydramine). Any thoughts?

What was the QTc?

diphenhydramine overdose

dragonfly99

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Daiphon

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njac

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DPIC

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J-Rad

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