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Drug Information Table

Sedating Antihistamines diphenhydramine


Therapeutic Use
Management of:
Mild allergic reactions
(seasonal allergic rhinitis,
cough, urticaria, mild
transfusion reaction)
Anaphylaxis (hypotension,
acute laryngeal edema,
bronchospasm)
Motion sickness
Insomnia Short-term use:
no longer than 2 consecutive
weeks (first-generation H1
antagonists)
Side/Adverse Effects

Administration
Do not crush or chew entericcoated formulations.
Do not take with alcohol or
other CNS depressants.
Take 30 min prior to activity for
motion sickness.

Interventions

Patient Instructions

Drowsiness, dizziness

Monitor the patient when


ambulating.
Recommend switching patient
to a nonsedating antihistamine
if sedation is excessive

Take the drug prior to or at


bedtime.
Avoid driving and activities that
require mental alertness.

Anticholinergic effects (dry


mouth, constipation)

Encourage sips of water or


sucking on hard candy

Suck on hard candy.

Gastrointestinal discomfort
(nausea, vomiting, constipation)

Give with food


Encourage high intake of fluids
Recommend selecting high
fiber foods on menu and
provide fiber supplement or
laxative as needed

Take the drug with food.


Increase fluid and fiber intake.
Take laxative as needed

Acute toxicity (flushed face,


high fever, tachycardia, dry
mouth, urinary retention, pupil
dilation in adults; excitation,
hallucinations, seizures in
children)

Monitor for urinary retention


Administer activated charcoal
and cathartics.
Administer acetaminophen
(Tylenol) and apply ice packs or
give sponge baths for fever.
Prepare to administer phenytoin
(Dilantin) IV for seizures

Report difficulty urinating


If symptoms of toxicity develop,
stop taking the drug.
Seek medical care.

Contraindications

Precautions

Interactions

Newborns and children under 2


years
Breastfeeding women
Narrow-angle glaucoma
Prostatic hypertrophy
Acute asthma exacerbation

Children
Older adults
History of asthma
Urinary retention
Open-angle glaucoma
Hypertension
Impaired kidney or liver function

Alcohol and other CNS


depressants increase
depressant effects of
antihistamines.