Medical Consequences of Over-the-Counter (OTC) Substance Abuse
John Brick in Handbook of the Medical Consequences of Alcohol and Drug Abuse, 2012
Use of butorphanol with intravenous diphenhydramine in a 1:1 mixture is described to cause an “unusual sensation” in the abdomen followed by confusion, clouded sensorium, inability to communicate, and stupor. Doses used are typically 75 mg of Benadryl with 3 mg of butorphanol. The dose is repeated until the desired effect is achieved. Initially, 150 to 225 mg of diphenhydramine is needed. Over time, tolerance requires doses as high as 450 to 750 mg of diphenhydramine. Adverse effects reported include: sedation, drowsiness, impairment of mental and physical performance, cloudy thinking, mood changes, dizziness, nausea, vomiting, respiratory depression, irregular breathing, and death from respiratory failure. Withdrawal effects are described, and include irritability, agitation, dysphoria, difficulty concentrating and sleeping, and emotional lability (Smith and Davis, 1984).
Personal testimonies
Jack Ryalls, Nick Miller in Foreign Accent Syndromes, 2014
I woke. It is early i could feel something biting my neck. I swipe it only to see it on my arm. Yuck! A spider! It looked hairy and brown in the sun light. But i could see a red mark on it. And it would be later when I remembered it. I hit it off, an jumped up. It was burning on my neck and i could feel my breathing hard. I was scared, and i told my son something was wrong … I thought the spider scared me to have heart trouble. But I begin to break out from head to toe with rash. I live very far out, so I have to have my niece take me to hospital. My nephew told me to take Benadryl. I toke them 3 within hour to help me breath. He said you’re having a reaction from the spider. Little did i know, my life was changing that minute …
Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Anton C. de Groot in Monographs in Contact Allergy, 2021
Currently, contact allergy to diphenhydramine (better known under one of its trade names, Benadryl) is rarely reported. Nevertheless, it was stated to be a common cause of allergic contact dermatitis in the USA in the 1980s (15), although another American author, in 1983, presenting 3 patients sensitized to diphenhydramine, could find only a few other case reports (24). However, 2 series of 19 (26) and 12 (27) cases of diphenhydramine hydrochloride dermatitis had previously been reported from the United Kingdom (data cited in ref. 24). Diphenhydramine has also caused some cases of photocontact dermatitis (see the section ‘Photosensitivity’ below) and systemic contact dermatitis (12,25).
A Case Study on Differential Diagnosis of Episodic Left Arm Numbness
Published in The Neurodiagnostic Journal, 2021
About 10 minutes into the recording, the patient became drowsy, eliciting rhythmic, mid-temporal theta activity and alpha wave attenuation. Stage N2 sleep soon followed marked by occasional vertex sharp transients, background slowing and spindles. During sleep, a focal right centroparietal electrographic seizure occurred starting with delta waves, then a buildup of beta wave activity (13–14 Hz) and evolving into sharply contoured theta activity progressing back to delta waves with intermixed spikes. (Figures 2–5). The seizure lasted 1 minute and 21 seconds with no clinical correlation. The neurologist was notified, and the patient was converted to long-term video EEG monitoring. Only 4 hours were captured before the patient disconnected himself by pulling off the electrodes. During that time, he had 9 more electrographic seizures, all stereotypically arising from the right central, parietal and occipital regions with a few spreading to the left side. Each lasted 2–3 minutes and had no obvious clinical correlate, with clear speech and interaction through the ones where family or staff were in the room. An hour before self-disconnecting, he received an intravenous (IV) fosphenytoin infusion, which was halted due to the patient becoming unbearably itchy, which likely led to the self-disconnection. This information was relayed to the medicine team and alternate antiseizure medication was advised with a reorder of continuous video EEG. 50 mg of Benadryl was administered, and the pruritus subsided.
Post Marketing Safety of Plus CBD™ Products, a Full Spectrum Hemp Extract: A 2-Year Experience
Published in Journal of Dietary Supplements, 2020
Stephen M. Schmitz, Hector L. Lopez, Osvaldo Marinotti
The second serious AE involved a 64 year old female consumer who reported that she was treated in the emergency room after experiencing shortness of breath and tongue swelling following her fourth dose of sublingual PlusCBD™ Oil Peppermint liquid. Within minutes of taking the product, she felt a burning in her mouth and tongue and a sensation of throat closing. She went to the ER and was treated with IV Benadryl. She felt better “immediately” and was discharged after two hours. No other therapy was administered. She had purchased two bottles of the same product from the same store. One week after the symptoms resolved, she used the other bottle without incident. Although the customer responded promptly to IV therapy and remained in the ER for only two hours, the case is considered an important medical event as IV therapy was required urgently. This customer stated she is generally healthy with no prior history of allergic-type reactions. In addition, she has used PlusCBD™ soft gels for more than a year without incident. The initial presentation of this case is a hypersensitivity reaction, and the customer was treated as such. The quick response to IV Benadryl is puzzling, as antihistamines do not typically work immediately, as epinephrine does. The customer was able to take the second bottle of the same product without incident, making a hypersensitivity reaction less likely.
Complications and posttreatment care following invasive laser skin resurfacing: A review
Published in Journal of Cosmetic and Laser Therapy, 2018
Dan Li, Shi-Bin Lin, Biao Cheng
Pruritus is usually mild to moderate and occurs during reepithelialization, lasting approximately 10 days. According to recent evidence, it is probably related to a yeast infection in the healing skin. Cool compresses and emollients may help relieve the symptoms. While more than half of patients who underwent ablative LSR treatment required antihistamines at night, the pruitus may be much milder following fractional LSR due to its minimally invasive nature. The most commonly used drugs include 25 mg of hydroxyzine hydrochloride (Atarax®) and 25–50 mg of diphenhydramine hydrochloride (Benadryl®), 2–3 times daily or once at night according to the symptom severity. Only rare cases of severe pruritus require systemic corticosteroids(67).
Related Knowledge Centers
- Blurred Vision
- Diphenhydramine
- Dizziness
- Rash
- Somnolence
- Cetirizine
- Allergy
- Antihistamine
- Acrivastine
- HIVes