DIPHENHYDRAMINE

Drug classes
Antihistamine
Anti-motion sickness agent
Sedative-hypnotic
Antiparkinsonian
Cough suppressant

Therapeutic actions
Competitively blocks the effects of histamine at H1-receptor sites, has atropine-like, antipruritic, and sedative
effects.

Indications
Relief of symptoms associated with perennial and seasonal allergic rhinitis; vasomotor rhinitis; allergic
conjunctivitis; mild, uncomplicated urticaria andangioedema; amelioration of allergic reactions to blood or
plasma; dermatographism; adjunctive therapy in anaphylactic reactions
Active and prophylactic treatment of motion sickness
Nighttime sleep aid
Parkinsonism (including drug-induced parkinsonism and extrapyramidal reactions), in the elderly
intolerant of more potent agents, for milder forms of the disorder in other age groups, and in combination with
centrally acting anticholinergic antiparkinsonian drugs
Syrup formulation: Suppression of cough due to colds or allergy

Indication for the Patient:

Contraindications and cautions
Contraindicated with allergy to any antihistamines, third trimester of pregnancy, lactation.
Use cautiously with narrow-angle glaucoma, stenosing peptic ulcer, symptomatic prostatic hypertrophy,
asthmatic attack, bladder neck obstruction,pyloroduodenal obstruction, pregnancy; elderly patients who may
be sensitive to anticholinergic effects.

IV facts
Preparation: No additional preparation required.
Infusion: Administer slowly each 25 mg over 1 min by direct injection or into tubing of running IV.
Incompatibilities: Do not combine with amobarbital, amphotericin B, cephalothin,
hydrocortisone, phenobarbital, phenytoin, thiopental.
Y-site incompatibilities: Do not mix with foscarnet.

Adverse effects
CNS: Drowsiness, sedation, dizziness, disturbed coordination, fatigue, confusion, restlessness,
excitation, nervousness, tremor, headache, blurred vision,diplopia
CV: Hypotension, palpitations, bradycardia, tachycardia, extrasystoles
GI: Epigastric distress, anorexia, increased appetite and weight gain, nausea, vomiting, diarrhea or
constipation
GU: Urinary frequency, dysuria, urinary retention, early menses, decreased libido, impotence
Hematologic: Hemolytic anemia, hypoplastic anemia,
thrombocytopenia, leukopenia, agranulocytosis, pancytopenia
Respiratory: Thickening of bronchial secretions, chest tightness, wheezing, nasal stuffiness, dry mouth,
dry nose, dry throat, sore throat
Other: Urticaria, rash, anaphylactic shock, photosensitivity, excessive perspiration

Interactions
Drug-drug
Possible increased and prolonged anticholinergic effects with MAOIs

Nursing considerations
Assessment
History: Allergy to any antihistamines, narrow-angle glaucoma, stenosing peptic ulcer,
symptomatic prostatic hypertrophy, asthmatic attack, bladder neck obstruction, pyloroduodenal obstruction,
third trimester of pregnancy, lactation
Physical: Skin color, lesions, texture; orientation, reflexes, affect; vision exam; P, BP; R, adventitious
sounds; bowel sounds; prostate palpation; CBC with differential

Interventions
Administer with food if GI upset occurs.
Administer syrup form if patient is unable to take tablets.
Monitor patient response, and arrange for adjustment of dosage to lowest possible effective dose.

Teaching points
Take as prescribed; avoid excessive dosage.
Take with food if GI upset occurs.
Avoid alcohol; serious sedation could occur.
These side effects may occur: Dizziness, sedation, drowsiness (use caution driving or performing tasks
requiring alertness); epigastric distress, diarrhea or constipation (take drug with meals); dry mouth (use
frequent mouth care, suck sugarless lozenges); thickening of bronchial secretions, dryness of nasal mucosa
(use a humidifier).
Report difficulty breathing, hallucinations, tremors, loss of coordination, unusual bleeding or bruising,
visual disturbances, irregular heartbeat.