A Case of Electrocardiographic and Mental Change in a Patient with a Diphenhydramine Overdose.
- Author:
Cheol Sang PARK
1
;
In Gu KANG
;
Hyun Sik RYU
;
Seong Soo PARK
;
Mi Jin LEE
;
Won Joon JEONG
Author Information
1. Department of Emergency Medicine, Konyang University College of Medicine, Daejeon, Korea. gardenjun@naver.com
- Publication Type:Case Report
- Keywords:
Diphenhydramine;
Electrocardiography;
Sodium bicarbonate;
Acidosis;
Overdose
- MeSH:
Acid-Base Equilibrium;
Acidosis;
Diphenhydramine;
Electrocardiography;
Humans;
Sodium Bicarbonate;
Sodium Channels;
Tachycardia, Sinus
- From:Journal of the Korean Society of Emergency Medicine
2010;21(3):405-411
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
The antihistaminic drug diphenhydramine is mainly used as a sedative, hypnotic and antiemetic. In many countries it is available over-the-counter, very common, and generally regarded as a harmless drug. However, diphenhydramine overdose can result in cardiotoxicity due to its ability to block fast sodium channels in a manner analogous to classic Vaughan-Williams type IA antidysrhythmic agents. As such, cardiotoxicity from diphenhydramine resembles that of the tricyclic antidepressant agents. Here we report a case of a 52 year old man who ingested 2,000 mg of diphenhydramine and presented with an altered mental state and an electrocardiographic change. His electrocardiogram showed sinus tachycardia with a rate 145 beat/min, a QRS interval of 88 ms, and a QTc of 556 ms. He had a wide anion gap metabolic acidosis. He was treated with intravenous sodium bicarbonate and supportive therapy. His clinical manifestations waned and he was transferred to another hospital nearby his hometown.
