Response of life threatening dimenhydrinate intoxication to sodium bicarbonate administration.
This is a report of an intentionally administered overdose of dimenhydrinate to a 4 month-old infant who subsequently presented with status epilepticus, coma, and life threatening ventricular dysrhythmias. Initial toxicologic analysis of the serum by fluorescence polarization immunoassay was positive for tricyclic antidepressants. Repeat analysis of the serum at 6 hours post ingestion by gas chromatography mass spectrometry analysis defined diphenhydramine 4.8 micrograms/mL. The infant was managed with IV sodium bicarbonate as utilized in tricyclic antidepressant intoxication. The dysrhythmias resolved and the infant recovered without sequelae.
Farrell
M
M
Division of Critical Care Medicine, Arnold Palmer Hospital for Children and Women, Orlando, FL 32806.
Heinrichs
M
M
Tilelli
J A
JA
D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001639:Bicarbonates / Q000627:therapeutic use*; D002649:Child Abuse; D004111:Dimenhydrinate / Q000097:blood / Q000506:poisoning*; D062787:Drug Overdose / Q000628:therapy; D008401:Gas Chromatography-Mass Spectrometry; D006321:Heart / Q000187:drug effects; D006801:Humans; D007223:Infant; D008297:Male; D012964:Sodium / Q000627:therapeutic use*; D017693:Sodium Bicarbonate; D013226:Status Epilepticus / Q000139:chemically induced*
D001639:Bicarbonates; D017693:Sodium Bicarbonate; D012964:Sodium; D004111:Dimenhydrinate