给一名患有先天性心脏病的婴儿静脉注射苯海拉明镇静后发生心脏骤停。
Cardiac Arrest Following the Administration of Intravenous Diphenhydramine for Sedation to an Infant With Congenital Heart Disease.
作者信息
Andersen Courtney L, Tobias Joseph D
出版信息
J Pediatr Pharmacol Ther. 2021;26(3):311-314. doi: 10.5863/1551-6776-26.3.311. Epub 2021 Mar 31.
Abstract
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.
摘要
苯海拉明（苯那君）是第一代抗组胺药，主要用于治疗过敏反应，包括过敏反应、荨麻疹和过敏性鼻炎。尽管它作为非处方药可以买到，但使用时可能会出现毒性，尤其是大剂量给药或静脉给药时。我们报告一例患有21三体综合征的3个月大婴儿，在儿科重症监护病房接受单次1.25mg/kg静脉注射苯海拉明用于镇静后立即发生心脏骤停。本文介绍了苯海拉明潜在的心血管和呼吸影响，回顾了既往关于危及生命不良反应的报道，并讨论了限制这些影响的方法。
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2
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3
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J Burn Care Res. 2015 Mar-Apr;36(2):266-71. doi: 10.1097/BCR.0000000000000066.
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8
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