Clinical and patient characteristics associated with severe outcome in diphenhydramine toxicity.
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Databases, Factual
Diphenhydramine
/ poisoning
Drug Overdose
Female
Histamine H1 Antagonists
/ poisoning
Humans
Illicit Drugs
/ poisoning
Infant
Infant, Newborn
Male
Middle Aged
Muscarinic Antagonists
/ poisoning
Oregon
Poisoning
/ diagnosis
Prognosis
Recreational Drug Use
Registries
Risk Assessment
Risk Factors
Substance-Related Disorders
/ complications
Suicide, Attempted
Young Adult
Diphenhydramine
dysrhythmias
endotracheal intubation
seizures
severe toxicity
Journal
Clinical toxicology (Philadelphia, Pa.)
ISSN: 1556-9519
Titre abrégé: Clin Toxicol (Phila)
Pays: England
ID NLM: 101241654
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
pubmed:
6
3
2021
medline:
9
11
2021
entrez:
5
3
2021
Statut:
ppublish
Résumé
Diphenhydramine is frequently misused and ingested recreationally for its antihistaminergic and antimuscarinic effects and is often involved in both serious and fatal poisonings, either in isolation or in combination with other xenobiotics. This analysis sought to determine which patient and encounter characteristics were associated with severe outcome after diphenhydramine overdose. This is an analysis of the multi-center ToxIC registry (2010-2016). Descriptive analysis of all cases with diphenhydramine listed as the "primary agent" contributing to toxicity were included. Analysis sought to determine which patient and encounter characteristics were associated with severe outcome, defined as occurrence of seizure, ventricular dysrhythmia, or intubation. To determine which patient and encounter characteristics were individually associated with severe outcome, we performed chi-square tests. Fisher's exact tests were used in the case of sparse data. We also performed multivariable logistic regression to further determine independent risk factors for severe outcome in diphenhydramine overdose. Eight hundred and sixty-three cases remained after exclusion with 15.6% ( Acidemia, QRS prolongation, and elevated anion gap are associated with severe outcomes in diphenhydramine toxicity. Further research is warranted to determine their predictive characteristics.
Sections du résumé
BACKGROUND
BACKGROUND
Diphenhydramine is frequently misused and ingested recreationally for its antihistaminergic and antimuscarinic effects and is often involved in both serious and fatal poisonings, either in isolation or in combination with other xenobiotics.
OBJECTIVE
OBJECTIVE
This analysis sought to determine which patient and encounter characteristics were associated with severe outcome after diphenhydramine overdose.
METHODS
METHODS
This is an analysis of the multi-center ToxIC registry (2010-2016). Descriptive analysis of all cases with diphenhydramine listed as the "primary agent" contributing to toxicity were included. Analysis sought to determine which patient and encounter characteristics were associated with severe outcome, defined as occurrence of seizure, ventricular dysrhythmia, or intubation. To determine which patient and encounter characteristics were individually associated with severe outcome, we performed chi-square tests. Fisher's exact tests were used in the case of sparse data. We also performed multivariable logistic regression to further determine independent risk factors for severe outcome in diphenhydramine overdose.
RESULTS
RESULTS
Eight hundred and sixty-three cases remained after exclusion with 15.6% (
DISCUSSION
CONCLUSIONS
Acidemia, QRS prolongation, and elevated anion gap are associated with severe outcomes in diphenhydramine toxicity. Further research is warranted to determine their predictive characteristics.
Identifiants
pubmed: 33666139
doi: 10.1080/15563650.2021.1891244
doi:
Substances chimiques
Histamine H1 Antagonists
0
Illicit Drugs
0
Muscarinic Antagonists
0
Diphenhydramine
8GTS82S83M
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM