Massive diphenhydramine poisoning resulting in a wide-complex tachycardia: successful treatment with sodium bicarbonate.
Diphenhydramine poisoning is characterized most often by anticholinergic effects. Cardiotoxicity and circulatory collapse have rarely been reported after massive ingestions of diphenhydramine and other H1-receptor-blocking agents, although these substances have local anesthetic properties and have been studied as antiarrhythmics. We report the case of a patient who developed a wide-complex tachycardia as a complication of acute diphenhydramine poisoning that responded to IV sodium bicarbonate.
Clark
R F
RF
Department of Medical Toxicology, Good Samaritan Regional Medical Center, Phoenix, Arizona.
Vance
M V
MV
D000293:Adolescent; D000428:Alcohol Drinking / Q000009:adverse effects*; D001639:Bicarbonates / Q000008:administration & dosage / Q000627:therapeutic use*; D001784:Blood Gas Analysis; D002606:Charcoal / Q000008:administration & dosage / Q000627:therapeutic use; D004155:Diphenhydramine / Q000506:poisoning* / Q000652:urine; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D005751:Gastric Lavage; D006801:Humans; D011041:Poisoning / Q000150:complications* / Q000652:urine; D012964:Sodium / Q000008:administration & dosage / Q000627:therapeutic use*; D017693:Sodium Bicarbonate; D013406:Suicide, Attempted; D013610:Tachycardia / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy*
D001639:Bicarbonates; D002606:Charcoal; D004155:Diphenhydramine; D017693:Sodium Bicarbonate; D012964:Sodium