Open AccessCardiac Arrest Following the Administration of Intravenous Diphenhydramine for Sedation to an Infant With Congenital Heart Disease
Author(s) -
Courtney Andersen,
Joseph D. Tobias
Publication year - 2021
Publication title -
the journal of pediatric pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.456
H-Index - 15
eISSN - 2331-348X
pISSN - 1551-6776
DOI - 10.5863/1551-6776-26.3.311
Subject(s) - diphenhydramine , medicine , antihistamine , anesthesia , sedation , adverse effect , respiratory arrest , pharmacology , histamine
Diphenhydramine (Benadryl) is a first-generation antihistamine that is used primarily to treat allergic reactions including anaphylaxis, urticaria, and allergic rhinitis. Despite its availability as an over-the-counter medication, toxicity may occur with its use especially when administered in large doses or via the intravenous route. We present a 3-month-old infant with Trisomy 21 who suffered a cardiac arrest immediately following administration of a single 1.25 mg/kg dose of intravenous diphenhydramine, prescribed for sedation in the Pediatric ICU setting. The potential cardiovascular and respiratory effects of diphenhydramine are presented, previous reports of life-threatening adverse effects reviewed, and options to limit these effects discussed.