Benadryl OD

zzyzx

zzyzx

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Have you guys ever experienced someone with a Benadryl OD? Have you seen ECG changes with that--i.e., wide QRS and long QT?
 
I saw tachycardia. And all the other symptoms from the toxidrome.

"Blind as a bat, mad as a hatter, red as a beet, hot as hell, dry as a bone."

The fact that there was an empty bottle of Benadryl was a good indicator as to what was going on. ;) I really had no idea Benadryl was a recreational drug. This chick that ODed on the stuff felt like crap. I know 50mg puts me out for a good 8 hours.
 
Picked up an elderly male patient from an ER yesterday to go back to the nursing home he came from, he had OD'd on Benadryl. He was still out of it a bit on arrival but suddenly perked up and started groping the female charge nurse...she wasn't too happy about that :rofl:
 
What's the tx for a diphenhydramine OD?
 
Fluids, rest, and monitoring I'd reckon.
 
I accidentally took a massive dose of Benadryl once. I was taking two meds with it in the ingredients and then taking it alone as well. Ended up pretty jacked up for a day. Twitchy, hot, couldn't get my legs to stop twitching in bed. Felt like I'd had way too much coffee. My mouth felt like it had sand in it. I didn't go to er and was fine by the next evening.
 
I saw an OD on Benadryl once. Pt took approximately a whole bottle, roughly 96 pills, managed to get behind the wheel, crossed a major highway, while avoiding getting slaughtered by another car, and passed out in a ditch in the median in the car. He ended up seizing 11 times en route, status epilepticus (roughly a 13 minute transport). He ended up getting a few stents and made it to live another day. He was sent to rehab following a stay in ICU. That was back when I was an EMT, I don't recall what his ECG looked like but he surely was jacked up!:glare::glare:
 
i recall the normal LD50 to be about 7g for an adult, which is alot... let me try to find the article and get back to you.
 
benadryl on top of being an antihistamine is an anticholinergic and has sodium channel blocking capibilities like 1a antiarrhythmics. This would explain the seizures, prolonged qt, and ventricular rhythms. Sodium bicarb is also used as a treatment.

Benadryl ods can present very similar to TCA ods.
There are other much smarter ppl here who could do a better job of explaining it than I.
 
There are cholinergic treatments available if you get that "anticholinergic syndrome, like physostigmine.
 
Random shots

Seen lots of recreational benedryl use. Some it affects more than others.
Saw one case ( not recreational) where a therapeutic IV dose re. onset of anaphylaxis caused the patient to become hallucinatory and frantic. Not red and dry.

Anyone remember Seldane, the first long chain antihistamine (low said effects)? It was removed from the market because people overused it (not enough side effects and MD"s treated it like "mother's milk") and suffered cardiac effects.
 
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