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MD (Chicago, Ill.) Apr 1947
Topics: Amino Acids; Anesthetics, General; Diphenhydramine; Drug Combinations; Ethers; Humans; Sorbitol
PubMed: 20294856
DOI: No ID Found -
Revista Medica de Chile Jan 1948
Topics: Diphenhydramine
PubMed: 18857535
DOI: No ID Found -
Fel'dsher I Akusherka Oct 1954
Topics: Diphenhydramine
PubMed: 13231969
DOI: No ID Found -
Transfusion Nov 2008
Topics: Acetaminophen; Anemia, Hemolytic; Diphenhydramine; Evidence-Based Medicine; Fever; Humans; Leukocyte Reduction Procedures; Premedication; Randomized Controlled Trials as Topic; Transfusion Reaction
PubMed: 19054374
DOI: 10.1111/j.1537-2995.2008.01924.x -
Annals of Allergy Aug 1993Children suffering from seasonal allergic rhinitis and matched normals were instructed on the use of a didactic computer simulation in a realistic classroom situation.... (Clinical Trial)
Clinical Trial
Children suffering from seasonal allergic rhinitis and matched normals were instructed on the use of a didactic computer simulation in a realistic classroom situation. Groups of atopic children received different treatments before instruction; ie, sedating (diphenylhydramine HCl) or nonsedating (loratadine) antihistamines or placebo. All returned after 2 weeks for an examination measuring factual and conceptual knowledge and the application of a learned strategy. Examination results showed large and consistent impairing effects of the allergic reaction on prior learning. Both the placebo and diphenhydramine groups learned significantly less than normal controls. The loratadine group's learning performance was superior to either of the other atopic groups' but still inferior to the normals'. Our conclusions are that the allergic reaction reduces learning ability in children and that this effect is partially counteracted by treatment with loratadine and aggravated by diphenhydramine.
Topics: Child; Cognition; Diphenhydramine; Female; Humans; Hypersensitivity, Immediate; Learning; Loratadine; Male; Rhinitis, Allergic, Seasonal
PubMed: 8346863
DOI: No ID Found -
Clinical Toxicology (Philadelphia, Pa.) Jul 2017
Topics: Adult; Diphenhydramine; Drug Overdose; Female; Half-Life; Humans; Male
PubMed: 28349707
DOI: 10.1080/15563650.2017.1296153 -
Diphenhydramine versus nonsedating antihistamines for acute allergic reactions: a literature review.Allergy and Asthma Proceedings 2007First-generation antihistamines can have adverse effects on the central nervous system and thereby complicate discharge planning from the emergency department (ED).... (Comparative Study)
Comparative Study Review
First-generation antihistamines can have adverse effects on the central nervous system and thereby complicate discharge planning from the emergency department (ED). Newer antihistamines are potentially safer, causing less sedation with similar efficacy. The aim of this study was to review the literature to better define which antihistamines are good options for the treatment of acute allergic reactions. A Medline search was conducted to identify English language articles published between January 1975 and March 2006 on antihistamines, sedation, and acute allergic reactions. Bibliographies from included studies were further investigated. We focused on sedative potential, effect on cognitive function, efficacy, onset of clinical activity, and cost of antihistamines. Diphenhydramine impairs psychomotor performance and cognitive function. Loratadine and desloratadine are nonsedating but less efficacious than cetirizine or fexofenadine. The incidence of sedation with cetirizine is less than that of first-generation antihistamines but is greater than placebo. Cetirizine has the fastest onset of action among the newer antihistamines. Fexofenadine does not impair psychomotor or cognitive skills and shows no dose-related increase in sedation but has a slower onset of action than diphenhydramine and cetirizine. Newer antihistamines cost approximately $0.52-2.39 more per dose than diphenhydramine ($0.37). Newer antihistamines provide similar efficacy as first-generation antihistamines but with less sedation. We believe this benefit outweighs the small increase in cost and that newer antihistamines should be considered in the management of acute allergic reactions. Although comparative ED-based trials are not available, newer antihistamines are an option for management of acute allergic reactions when sedation is a concern.
Topics: Acute Disease; Diphenhydramine; Histamine H1 Antagonists, Non-Sedating; Humans; Hypersensitivity; Treatment Outcome
PubMed: 17883909
DOI: 10.2500/aap.2007.28.3015 -
Emergency Medicine Journal : EMJ May 2018To determine the effectiveness of prophylactic anticholinergic medications in reducing extrapyramidal symptoms in patients taking acute antiemetics with a dopamine D2... (Meta-Analysis)
Meta-Analysis Review
Effects of prophylactic anticholinergic medications to decrease extrapyramidal side effects in patients taking acute antiemetic drugs: a systematic review and meta-analysis.
OBJECTIVES
To determine the effectiveness of prophylactic anticholinergic medications in reducing extrapyramidal symptoms in patients taking acute antiemetics with a dopamine D2 receptor antagonist effect.
METHODS
Systematic searches of all published studies through March 2017 were identified from PubMed, Cochrane library, Embase, Web of Science and Scopus. Only randomised controlled trials of patients receiving dopamine D2 antagonist antiemetic therapy for acute migraine in which an anticholinergic or placebo was compared were included. Pooled ORs were calculated for incidence of extrapyramidal symptoms and sedation.
RESULTS
Four placebo-controlled randomised controlled trials consisting of 737 patients met the inclusion criteria for our meta-analysis. The effect of diphenhydramine differed depending on the method of administration of the antiemetic. When the antiemetic was delivered as a 2 min antiemetic bolus, the odds of extrapyramidal symptoms were significantly reduced in the diphenhydramine group compared with placebo (OR 0.42; 95% CI 0.22 to 0.81; P=0.01). However, when the antiemetic was given as a 15 min infusion, there was no significant difference in extrapyramidal symptoms with or without diphenhydramine (OR 1.06; 95% CI 0.58 to 1.91; P=0.85). The lowest incidence of extrapyramidal symptoms was observed in patients receiving a 15 min antiemetic infusion without diphenhydramine prophylaxis (9.8%). In two trials including 351 patients that dichotomously reported sedation scales, diphenhydramine had significantly higher rates of sedation (31.6%vs19.2%, OR 2.01, 95% CI 1.21 to 3.33; P=0.007).
CONCLUSION
Prophylactic diphenhydramine reduces extrapyramidal symptoms in patients receiving bolus antiemetic therapy with a dopamine D2 antagonist effect, but not when it is given as an infusion. Because of significantly greater sedation with diphenhydramine, the most effective strategy is to administer the D2 antagonist antiemetic as a 15 min infusion without prophylaxis.
Topics: Antiemetics; Basal Ganglia Diseases; Cholinergic Antagonists; Diphenhydramine; Humans
PubMed: 29431143
DOI: 10.1136/emermed-2017-206944 -
JAMA Oct 1986
Topics: Diphenhydramine; Humans; Substance Withdrawal Syndrome; Substance-Related Disorders
PubMed: 3761494
DOI: No ID Found -
DICP : the Annals of Pharmacotherapy Feb 1991Diphenhydramine hydrochloride is an antihistamine with anticholinergic properties that is frequently used both orally and topically for the temporary relief of pruritus.... (Review)
Review
Diphenhydramine hydrochloride is an antihistamine with anticholinergic properties that is frequently used both orally and topically for the temporary relief of pruritus. Significant systemic absorption may occur following topical administration of diphenhydramine in patients with varicella-zoster lesions. We describe three children with varicella-zoster infection (VZI) who developed bizarre behavior as well as visual and auditory hallucinations following topical applications of large amounts of diphenhydramine to the majority of skin surfaces. In two cases, oral diphenhydramine was also administered. Serum diphenhydramine concentrations approximated or exceeded those previously reported. In each case, a complete resolution of mental status abnormalities occurred within 24 hours after discontinuation of all diphenhydramine-containing products. Pharmacists and other health professionals should be aware of the potential toxicity of topical diphenhydramine in patients with VZI.
Topics: Administration, Cutaneous; Administration, Oral; Chickenpox; Child; Child, Preschool; Diphenhydramine; Hallucinations; Humans; Male; Pruritus
PubMed: 2058184
DOI: 10.1177/106002809102500204