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Information on diphenhydramine hcl, a medication used for various indications including anaphylaxis and antiemetic purposes. Details on its mechanism of action, contraindications, adverse reactions, dosage, routes of administration, and special notes.
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GD-038-PHS-EMS: Drug Profile for Diphenhydramine HCl
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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.
Indications and Field Use:
Anaphylaxis (2nd line) Phenothiazine reactions (extrapyramidal symptoms) Antiemetic
Contraindications: Known hypersensitivity to diphenhydramine or drugs of similar chemical structure. Newborn or premature infants; nursing mothers. Considerable caution in patients with glaucoma, acute narrow angle; stenosing or obstructive diseases of the GI tract; bronchial asthma; hyperthyroidism; cardiovascular disease or hypertension; age greater than 60 years (all relative benefit vs risk).
Adverse Reactions:
CV: Hypotension; palpitations; arrhythmias; hemolytic anemia. Resp: Anaphylaxis; thickening of bronchial secretions, tightness in chest; wheezing; nasal stuffiness. CNS: Sedation; visual disturbances; seizures. GU/GI: Urinary frequency or retention; vomiting. Children: In children, may cause paradoxical CNS excitation, seizures, palpitations, thickening of bronchial secretions.
NOTES ON ADMINISTRATION
Incompatibilities/Drug Interactions:
Additive effects with alcohol and other CNS depressants (hypnotics, sedatives, tranquilizers, etc.). MAO inhibitors prolong and intensify anticholinergic (drying) effects.
GD-038-PHS-EMS: Drug Profile for Diphenhydramine HCl
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Adult Dosage:
Anaphylaxis: 25-50 mg slow IV push or deep IM. Extrapyramidal symptoms and antiemetic: 10-50 mg IV or deep IM, dose should be 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
Routes of Administration:
IV, Deep IM
Onset of Action:
IV 5 - 10 minutes
Peak Effects:
1 hour
Duration of Action:
3-6 hours
Dosage Forms/Packaging:
50 mg/1 ml syringes and vials
Arizona Drug Box Supply Range:
PARAMEDIC: 1 - 2 units INTERMEDIATE: 1 - 2 units
Special Notes:
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.