AI Article Synopsis
- Diphenhydramine toxicity is characterized by anticholinergic effects, and while most cases are treated supportively, some may present with severe symptoms like wide complex tachycardia due to sodium channel blockage.
- In addition to sodium bicarbonate for treatment, lidocaine and hypertonic saline can be used if arrhythmias do not respond.
- A case study details a 30-year-old woman who experienced seizures and cardiovascular collapse after diphenhydramine ingestion, showing significant improvement after the administration of intravenous fat emulsion, despite its rare report in sole diphenhydramine cases.
Article Abstract
Diphenhydramine toxicity manifests with signs of anticholinergic toxicity; therapy is generally supportive. In rare cases, patients can also present with a wide complex tachycardia due to sodium channel blockade. Treatment involves sodium bicarbonate. Lidocaine and hypertonic saline are used for arrhythmias refractory to sodium bicarbonate. Although intravenous fat emulsion (IFE) therapy is proposed as an adjunctive therapy due to the lipophilicity of diphenhydramine (octanol/water partition coefficient of 3.3), successful use of IFE after a confirmed sole ingestion of diphenhydramine is not previously reported. We present the case of a 30-year-old woman presenting with seizures, a wide complex tachycardia, and cardiovascular collapse after an ingestion of diphenhydramine refractory to other therapies with rapid improvement after IFE administration.
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| http://dx.doi.org/10.1097/MJT.0b013e318281191b | DOI Listing |
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