Diphenhydramine overdose
Diphenhydramine is one of the earliest antihistamines. It has a pronounced antiallergic, hypnotic and sedative effect, available in the form of tablets, ampoules and syringe tubes.
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How much diphenhydramine is needed for an overdose?
An overdose in an adult occurs in the case of taking diphenhydramine in a dose exceeding 0.25 g (more than 5 tablets), i.e., above the maximum permissible daily dose. Doses above 40 g are fatal.
In people with impaired liver or kidney function, the metabolism of diphenhydramine in the body is abnormal. In this case, even therapeutic doses of the drug can lead to overdose.
Diphenhydramine is especially dangerous for people in a state of alcoholic intoxication, since in combination with alcohol, the inhibitory effect of an antihistamine on the central nervous system increases sharply. In this case, signs of severe overdose can also be observed when taking a therapeutic dose.
Signs of overdose
An overdose of diphenhydramine is characterized by:
- drowsiness;
- general weakness, lethargy and apathy;
- dry mouth, strong thirst;
- redness of the skin;
- nausea, in some cases, and vomiting;
- headache, dizziness;
- lowering blood pressure;
- dyspnea;
- visual impairment;
- muscle twitching, with severe overdose, turning into convulsive seizures;
- delusions and hallucinations;
- loss of consciousness;
- heart rhythm disturbances;
- coma.
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First aid for overdose of diphenhydramine
In case of an overdose of diphenhydramine, first aid measures should be taken immediately.
While (and if) the victim is conscious, he should rinse the stomach. To do this, you must drink at least ½ liter of cool water (warm, and even more so hot water will accelerate the absorption of Diphenhydramine), after which they induce vomiting, irritating the root of the tongue. If a person is unconscious or an overdose of Diphenhydramine happened in a child in the first years of life, then it is strictly forbidden to flush the stomach with this method! Violation of this rule can lead to the penetration of vomit into the airways with subsequent obstruction or the development of aspiration pneumonia.
Then the victim needs to drink Activated charcoal (at the rate of 1-2 tablets for every 10 kg of body weight), Smecta or any other enterosorbent.
An overdose of diphenhydramine is characterized by intense thirst. Victims need to drink as much water as they want. Drinking plenty of fluids will reduce the concentration of diphenhydramine in the blood serum, and in addition, it will help to increase the amount of urine separated and thereby eliminate the toxic substance from the body.
Antidote
There is no specific antidote to Diphenhydramine.
When is medical attention required?
In case of an overdose of Diphenhydramine, medical attention is necessary in any case, even with the apparent well-being of the victim. Moreover, it is needed when taking high doses or an overdose that has happened in the elderly, children or persons in a state of alcoholic intoxication.
In the hospital, the patient is washed the stomach through a gastric tube, and given drugs with an absorbing effect. To accelerate the excretion of diphenhydramine from the body, forced diuresis is performed with alkalinization of blood plasma.
Correction of existing disorders of the respiratory system, cardiovascular and nervous systems is also carried out.
In case of severe respiratory failure, tracheal intubation and connection of the patient to a ventilator (artificial lung ventilation) are indicated.
Possible consequences
Large doses of diphenhydramine have a pronounced toxic effect on blood cells, as a result of which the result of an overdose is often thrombocytopenia and hemolytic anemia. A decrease in platelet count can cause the development of internal and external bleeding. The substances formed during the destruction of red blood cells (hemolysis) clog the renal tubules, thereby contributing to the development of acute renal failure.
Severe overdose of diphenhydramine can be fatal.
Elena Minkina Doctor anesthesiologist-resuscitator About the author
Education: graduated from the Tashkent State Medical Institute, specializing in general medicine in 1991. Repeatedly passed refresher courses.
Work experience: anesthesiologist-resuscitator of the city maternity complex, resuscitator of the hemodialysis department.
The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
