Benedryl

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TheUnderTaker

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22 y/o female called for possible benedryl allergy. Presented with hot flushed skin, pupils normal sugar 88 bp 160/100. Agitated shakey. Normal speech with mild twitching. No medical history, not pregnant. not tired, complaining of dry mouth. Could this possibly be a serotonin spike caused by benedryl's ability to act like a mild SSRI paired with anxiety. causing this panic. Or just the side effects of high bp and being sick
 
A Benadryl (not benedryl) allergy would be unusual. Benadryl and other antihistamines help suppress allergic reactions. If you'd like to learn more about that med, Google diphenhydramine -- the generic drug.

The shaking and agitation could be a side effect of Benadryl, although standard doses more often cause mild sedation. The dry mouth is a common side effect of Benadryl. Blood pressure post-Benadryl could be higher or lower than normal. Tachycardia wouldn't be unusual, nor would pupil dilation.

It's not all that uncommon to see Benadryl abused, so I'd be wondering what else the patient may have taken.

Just so you know, the patient's presenting problem could have been caused by hundreds of conditions and may have nothing to do with Benadryl.
 
TheUnderTaker said:
22 y/o female called for possible benedryl allergy. Presented with hot flushed skin, pupils normal sugar 88 bp 160/100. Agitated shakey. Normal speech with mild twitching. No medical history, not pregnant. not tired, complaining of dry mouth. Could this possibly be a serotonin spike caused by benedryl's ability to act like a mild SSRI paired with anxiety. causing this panic. Or just the side effects of high bp and being sick
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Sounds more like a Benadryl overdose, not a Benadryl allergy.
 
I'd also consider a paradoxical reaction, I've never seen one in an adult but I've seen plenty in peds. Add some baseline anxiety and people wig out.
 
My question is what was she taking the Benadryl for in the first place? is this a reaction due to the Benadryl or is this simply a continuation of symptoms that were present and the Benadryl did not relieve?
 
TheUnderTaker said:
22 y/o female called for possible benedryl allergy. Presented with hot flushed skin, pupils normal sugar 88 bp 160/100. Agitated shakey. Normal speech with mild twitching. No medical history, not pregnant. not tired, complaining of dry mouth. Could this possibly be a serotonin spike caused by benedryl's ability to act like a mild SSRI paired with anxiety. causing this panic. Or just the side effects of high bp and being sick
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To clarify was complaining of dry mouth or wasn't?

If so, definitely some anticholinergic effects (dry mouth, flushed, agitation, irritability) of benadryl as mentioned by others. And even if no dry mouth, still my no. 1 differential.
 
silver said:
To clarify was complaining of dry mouth or wasn't?

If so, definitely some anticholinergic effects (dry mouth, flushed, agitation, irritability) of benadryl as mentioned by others. And even if no dry mouth, still my no. 1 differential.
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+1 for anticholinergic toxicity. The symptoms are classic, but it is unusual to see in such a young person - it is apparently more common in older people.

What else was going on with her? Some other medical issues, or did she just take a ton of it?
 
With 1st gen antihistamines, which have good tendency to cross the blood-brain barrier, about some people exhibit anticholinergic effects at traditionally therapeutic doses. About 5% of adults will have some level of anticholinergic effects at 50mg PO.
 
Gurby said:
+1 for anticholinergic toxicity. The symptoms are classic, but it is unusual to see in such a young person - it is apparently more common in older people.

What else was going on with her? Some other medical issues, or did she just take a ton of it

there was no other issues. took the recommended dose of 2 tablets.
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silver said:
To clarify was complaining of dry mouth or wasn't?

If so, definitely some anticholinergic effects (dry mouth, flushed, agitation, irritability) of benadryl as mentioned by others. And even if no dry mouth, still my no. 1 differential.
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Yes dry mouth, cotton mouth
 
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And sometimes if they take enough they go into polymorphic vtach
 
from the OP none of those are allergy symptoms that you would have to worry about, if it was due to allergies to Benadryl and not Anticholinergic side effects; but people are allergic to Benadryl.
Hopefully they are awake enough to tell you that they are, and not to give it to them
 
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