Prototype medcard diphenhydramine (Benadryl, others)

diphenhydramine
(Benadryl, others)
Class: Antihistamines -Block the release or action of histamine which is a chemical released during inflammation that increases secretions and narrows airways. They are found in many OTC prep. that are designed to relieve respiratory symptoms and allergies.

Indication:
Symptomatic relief of perennial and seasonal rhinitis, vasomotor rhinitis, allergic conjunctivitis, urticaria, and angioedema; also used for treating motion sickness and parkinsonism and as a nighttime sleep aid and to suppress coughs.

Action
Competitively blocks the effects of histamine and H1 receptor sites;
has atropine-like antiprutitic and sedative effects

Pharmacokinetics
Route Onset Peak Duration
P.O. 15 to 30 min 1 to 4 hr 4 to 7 hr
I.V. Immediate 1 to 4 hr 4 to 8 hr
I.M. 20-30 min 1 to 4 hr 4 to 8 hr
T1/2 : 2.5-7 hours Metabolized in Liver excreted in Urine

Adverse Effects
Drowsiness, sedation dizziness epigastric distress thickening of bronchial secretions, urinary frequency, rash, bradycardia

Drug Interactions
apomorphine: Possibly decreased emetic response in treatment of poisoning
barbiturates, other CNS depressants: Possibly increased CNS depression
MAO inhibitors: Increased anticholinergic and CNS depressant effects of diphenhydramine
Alcohol can cause an increase in CNS depression

Contraindications and Caution
Antihistamines are contraindicated during pregnancy or lactation
caution in renal or hepatic impairment (can alter the metabolism and excretion)

Nursing Considerations
Expect to give parenteral form of diphen-hydramine only when oral ingestion isn’t possible.
Keep elixir container tightly closed. Protect elixir and parenteral forms from light.
Expect to discontinue drug at least 72 hours before skin tests for allergies because drug may inhibit cutaneous histamine response, thus producing false-negative results.

Patient Education
Instruct patient to take diphenhydramine at least 30 minutes before exposure to situations that may cause motion sickness.
Advise her to take drug with food to minimize GI distress.
Urge patient to avoid alcohol while taking diphenhydramine.
Instruct her to use sunscreen to prevent photosensitivity reactions.
Advise patient to avoid taking other OTC drugs that contain diphenhydramine to prevent additive effects.

Source
Karch. Focus on Pharmacology pp. 867-869
ATI online Drug Guide

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