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Show Me the Evidence: Is the Routine Use of Premedication for Transfusion Really Necessary?
Improvements in transfusion medicine, blood typing, and donor screening have reduced the likelihood of a reaction from administration of blood products. In an effort to prevent transfusion reactions, our current standard is to administer acetaminophen 650mg and diphenhydramine 25mg, 30 minutes before transfusions. This practice may unnecessarily place patients at increased risk for complications including falls, cognitive impairment, and hepatic toxicity. (Source: Biology of Blood and Marrow Transplantation)
Source: Biology of Blood and Marrow Transplantation - January 24, 2015 Category: Hematology Authors: Julie Schutte, Ashlee Kwiatkowski, Jim Wischmeier, Sherry Amelung, Valerie Dougherty, Greg Voelkel, Eve Weber, Susan Hankins, Megan Colburn, Cheryl Wilson, Rebekah Flynn, Joyce Divanbeigi, Chris Rimkus Tags: Transplant Nursing Research Source Type: research

Massive attack by honeybees in a German shepherd dog: description of a fatal case and review of the literature
In the present study, a fatal case caused by honeybee (Apis cerana) stings was documented in a female German shepherd dog that was presented at the Veterinary Teaching Hospital, University of Agriculture Faisalabad, Pakistan. Characteristic clinical signs included hematuria, hematemesis, incoordination and convulsions along with evidence of massive honeybee attack supported the diagnosis of envenomation. The dog was treated with dexamethasone and diphenhydramine, but it did not respond to therapy and died. This outcome could be avoided if we had a bee antivenom available for treating envenomated patients. (Source: Journal ...
Source: Journal of Venomous Animals and Toxins including Tropical Diseases - January 23, 2015 Category: Tropical Medicine Source Type: research

Saving two lives with one dialysis treatment Successful treatment of life threatening diphenhydramine intoxication by intermittent hemodialysis using a high cut-off membrane.
We present a potentially lifethreatening diphenhydramine (DPH) overdose in a stuporous female patient in which high cut-off hemodialysis was used. Timely detoxification resulted in rapid gain of consciousness, allowing the patient to state the existence and location of another poison victim. PMID: 25600858 [PubMed - as supplied by publisher] (Source: Clinical Nephrology)
Source: Clinical Nephrology - January 20, 2015 Category: Urology & Nephrology Authors: Baroke E, Schmidt JJ, Strunk AK, Wiesner O, Kühn-Velten WN, Kielstein JT Tags: Clin Nephrol Source Type: research

Double-blind, randomized, controlled, crossover trial of pregabalin for neurogenic claudication
Conclusions: Pregabalin was not more effective than active placebo in reducing painful symptoms or functional limitations in patients with neurogenic claudication associated with lumbar spinal stenosis. Classification of evidence: This study provides Class I evidence that for patients with neurogenic claudication, compared with diphenhydramine, pregabalin does not increase the time to moderate pain during a treadmill test. (Source: Neurology)
Source: Neurology - January 19, 2015 Category: Neurology Authors: Markman, J. D., Frazer, M. E., Rast, S. A., McDermott, M. P., Gewandter, J. S., Chowdhry, A. K., Czerniecka, K., Pilcher, W. H., Simon, L. S., Dworkin, R. H. Tags: All Clinical trials, Neuropathic pain, All Spinal Cord ARTICLE Source Type: research

Hypnotic use and multiple sclerosis related fatigue: a forgotten confounder.
In this issue of Sleep Medicine, Braley et al. [1] have published a cross-sectional study of 190 multiple sclerosis (MS) patients, showing that over-the-counter (OTC) hypnotic use, but not prescription hypnotic use, was independently associated with fatigue measured with the Fatigue Severity Scale (FSS) [2] after adjustment for insomnia (measured with the Insomnia Severity Index (ISI) [3]) and other clinical and sleep related confounds. Almost half (47%) of MS patients reported occasional or more frequent use of hypnotics, and the majority of them indicated the use of an OTC diphenhydramine-containing product. (Source: Sleep Medicine)
Source: Sleep Medicine - January 16, 2015 Category: Sleep Medicine Authors: Christian Veauthier Tags: Editorial Source Type: research

Hypersensitivity to Laminaria: A Case Report and Review of Literature
We report a case of laminaria hypersensitivity treated with diphenhydramine and corticosteroids. A literature review identified 10 previously reported cases, with 8 recognized as anaphylaxis, and good outcomes with corticosteroids and antihistamines despite limited epinephrine utilization. Laminaria hypersensitivity is likely IgE mediated with an increased anaphylaxis risk with prior exposure. (Source: Contraception)
Source: Contraception - January 13, 2015 Category: OBGYN Authors: Tania Sierra, Melissa M. Figueroa, Katherine T. Chen, Britt Lunde, Adam Jacobs Tags: Original research article Source Type: research

Allergy to sunflower seed and sunflower butter as proposed vehicle for sensitization
Conclusions: A case of sunflower allergy in the context of household consumption of sunflower butter has not yet been reported. We suggest that homes which are intentionally peanut-safe may provide an environment whereby infants with impaired skin barrier are at increased risk of allergy to alternative ?butter? products being used, via cutaneous exposure to these products preceding oral introduction to the child. (Source: Allergy, Asthma and Clinical Immunology)
Source: Allergy, Asthma and Clinical Immunology - January 8, 2015 Category: Allergy & Immunology Authors: Elana LavineMoshe Ben-Shoshan Source Type: research

Ventricular Dysrhythmias Associated with Poisoning and Drug Overdose: A 10-Year Review of Statewide Poison Control Center Data from California
Conclusions Antidepressants and stimulants were the most common drugs associated with ventricular dysrhythmias. Patients with suspected poisonings by medications with a high risk of ventricular dysrhythmia warrant prompt ECG monitoring. (Source: American Journal of Cardiovascular Drugs)
Source: American Journal of Cardiovascular Drugs - January 8, 2015 Category: Cardiology Source Type: research

Evaluation of Treatments for Pruritus in Epidermolysis Bullosa
The objective of the current study was to determine quantitatively which treatments individuals with EB have used for pruritus and to evaluate the perceived effectiveness of these treatments in pruritus relief. A questionnaire was developed to evaluate the treatments and therapies used for pruritus in patients of all ages and for all types of EB. Questions about bathing products, moisturizers, topical products, oral medications, dressings, and alternative therapies were included. A 5‐point Likert scale (−2 = relieves itch a lot, −1 = relieves itch a little, 0 = no change, 1 = increases itch a little, 2 = in...
Source: Pediatric Dermatology - December 29, 2014 Category: Dermatology Authors: Christina Danial, Rasidat Adeduntan, Emily S. Gorell, Anne W. Lucky, Amy S. Paller, Anna L. Bruckner, Elena Pope, Kimberly D. Morel, Moise L. Levy, Shufeng Li, Elaine S. Gilmore, Alfred T. Lane Tags: Original Article Source Type: research

Honey for acute cough in children.
CONCLUSIONS: Honey may be better than 'no treatment', diphenhydramine and placebo for the symptomatic relief of cough, but it is not better than dextromethorphan. None of the included studies assessed the effect of honey on 'cough duration' because intervention and follow-up were for one night only. There is no strong evidence for or against the use of honey. PMID: 25536086 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - December 23, 2014 Category: Journals (General) Authors: Oduwole O, Meremikwu MM, Oyo-Ita A, Udoh EE Tags: Cochrane Database Syst Rev Source Type: research

Late-breaking abstract: Antitussive effect of a diphenhydramine-containing multicomponent cough syrup in acute viral cough
ConclusionOur results provide the initial evidence of the ability of diphenhydramine to inhibit cough reflex sensitivity in subjects with acute pathological cough. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Dicpinigaitis, P., Dhar, S., Johnson, A., Gayle, Y., Brew, J., Caparros-Wanderley, W. Tags: 5.1 Airway Pharmacology and Treatment Source Type: research

Doxepin and diphenhydramine increased non-rapid eye movement sleep through blockade of histamine H1 receptors
Publication date: Available online 11 December 2014 Source:Pharmacology Biochemistry and Behavior Author(s): Yi-Qun Wang , Yohko Takata , Rui Li , Ze Zhang , Meng-qi Zhang , Yoshihiro Urade , Wei-Min Qu , Zhi-Li Huang Histaminergic neurons have been reported to play an important role in the regulation of sleep-wake behavior through the histamine H1 receptor (R, H1R). First generation H1R antagonists, such as doxepin and diphenhydramine, produce drowsiness in humans, and are occasionally used to treat insomnia. However, if H1R antagonists function via physically blocking the H1R remains unclear. In the current study, we u...
Source: Pharmacology Biochemistry and Behavior - December 11, 2014 Category: Biochemistry Source Type: research

Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia
Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population. (Source: International Journal of Clinical Pharmacy)
Source: International Journal of Clinical Pharmacy - December 9, 2014 Category: Drugs & Pharmacology Source Type: research

In vitro detection of cardiotoxins or neurotoxins affecting ion channels or pumps using beating cardiomyocytes as alternative for animal testing.
Abstract The present study investigated if and to what extent murine stem cell-derived beating cardiomyocytes within embryoid bodies can be used as a broad screening in vitro assay for neurotoxicity testing, replacing for example in vivo tests for marine neurotoxins. Effect of nine model compounds, acting on either the Na(+), K(+), or Ca(2+) channels or the Na(+)/K(+) ATP-ase pump, on the beating was assessed. Diphenhydramine, veratridine, isradipine, verapamil and ouabain induced specific beating arrests that were reversible and none of the concentrations tested induced cytotoxicity. Three K(+) channel blockers, a...
Source: Toxicology in Vitro - December 2, 2014 Category: Toxicology Authors: Nicolas J, Hendriksen PJ, de Haan LH, Koning R, Rietjens IM, Bovee TF Tags: Toxicol In Vitro Source Type: research

An LC-MS/MS method for the simultaneous determination of lycorine and galanthamine in rat plasma and its application to pharmacokinetic study of Lycoris radiata extract in rats
Summary A rapid, sensitive, and selective liquid chromatography-tandem mass spectrometry was developed for the simultaneous determination of lycorine and galanthamine, two major constituents in Lycoris radiata extract, in rat plasma. Liquid-liquid extraction with ethyl ether was carried out using diphenhydramine as the internal standard. The two bioactive alkaloids were separated on a Zorbax SB-C18 reserved-phase column (150 mm × 4.6 mm, i.d., 5 μm) by gradient elution using a mobile phase consisting of methanol with 0.1% formic acid (A) and water with 0.1% formic acid (B) at a flow rate of 0.6 mL/min. All anal...
Source: Journal of Huazhong University of Science and Technology -- Medical Sciences -- - December 1, 2014 Category: Research Source Type: research

Acute vocal fold dystonic reaction to Propofol: A case report
Publication date: Available online 20 November 2014 Source:American Journal of Otolaryngology Author(s): Rachel C. Steckelberg , David Tsiang , Kelly Pettijohn , Abie Mendelsohn , Nir Hoftman A 67-year old male underwent uneventful robotic-assisted thorascopic resection of a solitary pulmonary fibrous tumor. Immediately following extubation at the completion of the surgical procedure, the patient developed respiratory distress that did not resolve with treatment. Benadryl provided only temporary relief. Midazolam and Hydromorphone were given for anxiolysis and analgesia respectively, which provided transient relief of sy...
Source: American Journal of Otolaryngology - November 28, 2014 Category: Endocrinology Source Type: research

The Case Files: The Effects of an Epidural Steroid Injection
This study showed that the duration of absorption of 50 ml of air decreased from 5.8 to 1.9 weeks by 40% FiO2 from 1.9 to 0.6 weeks on room air and 100% FiO2, respectively. (Anesthesiology 1996;84[2]:442.)     Several diagnoses should be added to the headache differential diagnosis in the case of a patient receiving recent epidural spinal injections. Post-procedural headache or low-pressure headache, as well as pneumocephalus, should be added to the differential. The patient can be easily placed on a face mask to expedite air resorption, and can be provided symptom control as needed. This patient was successfully manag...
Source: The Case Files - November 21, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Stability of i.v. admixture containing metoclopramide, diphenhydramine hydrochloride, and dexamethasone sodium phosphate in 0.9% sodium chloride injection.
CONCLUSION: An i.v. admixture containing metoclopramide 1.6 mg/mL, diphenhydramine hydrochloride 2 mg/mL, and dexamethasone sodium phosphate 0.16 mg/mL in 0.9% sodium chloride injection was chemically stable for 48 hours when stored at room temperature without light protection. PMID: 25404598 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 20, 2014 Category: Drugs & Pharmacology Authors: Kintzel PE, Zhao T, Wen B, Sun D Tags: Am J Health Syst Pharm Source Type: research

Variability of bioavailability and intestinal absorption characteristics of bisoprolol.
Authors: Ishida K, Horie A, Nishimura M, Taguchi M, Fujii N, Nozawa T, Inoue H, Hashimoto Y Abstract We previously reported that renal function is partly responsible for the interindividual variability of the pharmacokinetics of bisoprolol. The aim of the present study was to examine the variability of bioavailability (F) of bisoprolol in routinely treated Japanese patients and intestinal absorption characteristics of the drug. We first analyzed the plasma concentration data of bisoprolol in 52 Japanese patients using a nonlinear mixed effects model. We also investigated the cellular uptake of bisoprolol using huma...
Source: Drug Metabolism and Pharmacokinetics - November 18, 2014 Category: Drugs & Pharmacology Tags: Drug Metab Pharmacokinet Source Type: research

Variability of bioavailability and intestinal absorption mechanisms of metoprolol.
Authors: Fukao M, Ishida K, Horie A, Taguchi M, Nozawa T, Inoue H, Hashimoto Y Abstract We previously reported that aging and/or cytochrome P450 2D6 polymorphism are responsible for the interindividual variability in the systemic clearance (CL) and bioavailability (F) of metoprolol. The aim of the present study was to evaluate the residual variability of F of metoprolol in routinely treated Japanese patients and to investigate the intestinal absorption mechanism of the drug using human intestinal epithelial LS180 cells. We first re-analyzed the blood concentration data for metoprolol in 34 Japanese patients using a...
Source: Drug Metabolism and Pharmacokinetics - November 18, 2014 Category: Drugs & Pharmacology Tags: Drug Metab Pharmacokinet Source Type: research

Modulatory effects of taurine on jejunal contractility.
Abstract Taurine (2-aminoethanesulfonic acid) is widely distributed in animal tissues and has diverse pharmacological effects. However, the role of taurine in modulating smooth muscle contractility is still controversial. We propose that taurine (5-80 mM) can exert bidirectional modulation on the contractility of isolated rat jejunal segments. Different low and high contractile states were induced in isolated jejunal segments of rats to observe the effects of taurine and the associated mechanisms. Taurine induced stimulatory effects on the contractility of isolated rat jejunal segments at 3 different low contractil...
Source: Braz J Med Biol Res - November 16, 2014 Category: Research Authors: Yao QY, Chen DP, Ye DM, Diao YP, Lin Y Tags: Braz J Med Biol Res Source Type: research

Efficacy and Tolerability of Benzodiazepines for the Treatment of Behavioral and Psychological Symptoms of Dementia: A Systematic Review of Randomized Controlled Trials
The objective of this review is to summarize the available data on the use of benzodiazepines for the treatment of behavioral and psychological symptoms of dementia (BPSD) from randomized controlled trials (RCTs). A systematic search of 5 major databases, PubMed, MEDLINE, PsychINFO, EMBASE, and Cochrane Collaboration, yielded a total of 5 RCTs. One study compared diazepam to thioridazine, 1 trial compared oxazepam to haloperidol and diphenhydramine, 1 trial compared alprazolam to lorazepam, 1 trial compared lorazepam to haloperidol, and 1 trial compared intramuscular (IM) lorazepam to IM olanzapine and placebo. The data in...
Source: American Journal of Alzheimer's Disease and Other Dementias - November 12, 2014 Category: Geriatrics Authors: Tampi, R. R., Tampi, D. J. Tags: Reviews Source Type: research

Effects of antihistamines on the function of Human α7-nicotinic acetylcholine receptors.
Abstract Effects of the histamine H1 receptor (H1R) antagonists (antihistamines), promethazine (PMZ), orphenadrine (ORP), chlorpheniramine (CLP), pyrilamine (PYR), diphenhydramine (DPH), citerizine (CTZ), and triprolidine (TRP) on the functional properties of the cloned α7 subunit of the human nicotinic acetylcholine receptor expressed in Xenopus oocytes were investigated. Antihistamines inhibited the α7- nicotinic acetylcholine receptor in the order PYR>CLP>TRP>PMZ>ORP≥DPH≥CTZ. Among the antihistamines, PYR showed the highest reversible inhibition of acetylcholine (100µM)-induced responses with ...
Source: European Journal of Pharmacology - November 8, 2014 Category: Drugs & Pharmacology Authors: Sadek B, Soha Khanian S, Ashoor A, Prytkova T, Ghattas MA, Atatreh N, Nurulain SM, Susan Yang KH, Christopher Howarth F, Oz M Tags: Eur J Pharmacol Source Type: research

Mouse anaphylactic shock is caused by reduced cardiac output, but not by systemic vasodilatation or pulmonary vasoconstriction, via PAF and histamine
Publication date: 29 October 2014 Source:Life Sciences, Volume 116, Issue 2 Author(s): Mofei Wang , Toshishige Shibamoto , Mamoru Tanida , Yuhichi Kuda , Yasutaka Kurata Aims Systemic anaphylaxis is life-threatening, and its pathophysiology is not fully clarified. Mice are frequently used for experimental study on anaphylaxis. However, the hemodynamic features and mechanisms of mouse anaphylactic hypotension remain unknown. Therefore, we determined mechanisms of systemic and pulmonary vascular response to anaphylactic hypotension in anesthetized BALB/c mice by using receptor antagonists of chemical mediators. Main metho...
Source: Life Sciences - November 4, 2014 Category: Biology Source Type: research

Life-Threatening Diphenhydramine Toxicity Presenting With Seizures and a Wide Complex Tachycardia Improved With Intravenous Fat Emulsion
We present the case of a 30-year-old woman presenting with seizures, a wide complex tachycardia, and cardiovascular collapse after an ingestion of diphenhydramine refractory to other therapies with rapid improvement after IFE administration. (Source: American Journal of Therapeutics)
Source: American Journal of Therapeutics - November 1, 2014 Category: Drugs & Pharmacology Tags: Case Report Source Type: research

Fatal diphenhydramine poisoning in a dog.
We report a fatal diphenhydramine poisoning of a 10-year-old, male poodle-cross dog with pre-existing conditions and suspected co-ingestion of ethanol. This case illustrates that diphenhydramine overdose can be fatal in certain circumstances and that analytical toxicology may play an important role in animal death investigations. PMID: 25392554 [PubMed - in process] (Source: The Canadian Veterinary Journal)
Source: The Canadian Veterinary Journal - November 1, 2014 Category: Veterinary Research Authors: Buchweitz JP, Raverty SA, Johnson MB, Lehner AF Tags: Can Vet J Source Type: research

Effect of ingested H antihistamines on methacholine challenge
Current guidelines recommend withholding H1 antihistamines before methacholine challenge.1 There does not appear to be much evidence to support this recommendation. We performed a double-blind random-order study comparing single-dose diphenhydramine, desloratadine, and cetirizine to placebo on the airway response to methacholine. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - October 24, 2014 Category: Allergy & Immunology Authors: Donald W. Cockcroft, Beth E. Davis, Yeonju Roh, Joe-Ann Lourens Tags: Letter to the Editor Source Type: research

Comparative Pharmacology and Toxicology of Pharmaceuticals in the Environment: Diphenhydramine Protection of Diazinon Toxicity in Danio rerio but Not Daphnia magna
Abstract Pharmaceuticals and other contaminants of emerging concern present unique challenges to environmental risk assessment and management. Fortunately, mammalian pharmacology and toxicology safety data are more readily available for pharmaceuticals than other environmental contaminants. Identifying approaches to read-across such pharmaceutical safety information to non-target species represents a major research need to assess environmental hazards. Here, we tested a biological read-across hypothesis from emergency medicine with common aquatic invertebrate and vertebrate models. In mammals, the antihistamine di...
Source: The AAPS Journal - October 18, 2014 Category: Drugs & Pharmacology Source Type: research

Flushing and pruritus secondary to prescription fish oil ingestion in a patient with allergy to fish
Conclusion Due to the patient’s allergic history, timing of onset/offset of the reaction, laboratory evidence, and the use of the Naranjo probability scale, prescription fish oil capsules were deemed the probable cause of this patient’s pruritus and flushing of the face and trunk. Practitioners and patients should always ensure they have an updated list of allergies within the patient’s medical record that includes medications as well as foods and food additives. (Source: International Journal of Clinical Pharmacy)
Source: International Journal of Clinical Pharmacy - October 16, 2014 Category: Drugs & Pharmacology Source Type: research

Septic Cavernous Sinus Thrombosis Caused by Sinusitis
By Ichwan, Brian MD; Barrie, Michael MD; Neltner, Kurt MD A 37-year-old man with no significant medical history presented to the emergency department with a headache. He described it as an insidious, constant severe pain that was initially localized occipital but progressed to a bitemporal distribution. His neurologic exam, extraocular movements, and visual acuity were all normal. The patient was given symptomatic treatment with compazine and Benadryl. He was responsive to therapy and discharged home after his headache symptoms resolved.   Seven days later, however, he presented to the emergency department with a worse...
Source: The Case Files - October 14, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Oil-in-water emulsion lotion providing controlled release using 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer as emulsifier
Publication date: 2012 Source:Results in Pharma Sciences, Volume 2 Author(s): Akiko Ishikawa , Makiko Fujii , Kumi Morimoto , Tomomi Yamada , Naoya Koizumi , Masuo Kondoh , Yoshiteru Watanabe Lotion is a useful vehicle for active ingredients used to treat skin disease because it can be applied to the scalp, can cover large areas of skin, and it is easy to spread due to low viscosity. An emulsion lotion (EL) containing 2-methacryloyloxyethyl phosphorylcholine n-butyl methacrylate copolymer (PMB) as an emulsifier that provides controlled-release was developed. Diphenhydramine (DPH) was used as a model drug. Formulation wit...
Source: Results in Pharma Sciences - October 12, 2014 Category: Drugs & Pharmacology Source Type: research

Common ocular effects reported to a poison control center after systemic absorption of drugs in therapeutic and toxic doses
Purpose of reviewOcular effects resulting from medications assist toxicologists in determining substances involved when treating a poisoned patient. The intention of this review is to discuss the most common ocular effects, the medications that cause them, and the mechanisms by which they occur. Recent findingsAccording to National Poison Data System, the most common reported ocular effects following a drug ingestion/injection/inhalation are mydriasis, miosis, and nystagmus. The most common drug/drug classes reported to a regional poison control center causing these ocular effects include the following: first, mydriasis ...
Source: Current Opinion in Ophthalmology - October 6, 2014 Category: Opthalmology Tags: OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read Source Type: research

Abstract 5041: The effect of YOCAS(C)(R) Yoga on prescription sleep medication and over-the-counter sleep medication usage in cancer survivors with impaired sleep quality
Background: Impaired sleep quality (ISQ) is highly prevalent among cancer survivors; 30-90% of cancer survivors report some form of ISQ following treatment. Cancer survivors with ISQ are often provided with sleep medications, which fall into two classes: prescription sleep medications (PSM) or over-the-counter sleep medications (OSM). The most common PSM are non-benzodiazepine hypnotics (NBH), benzodiazepines (BENZO), and tricyclic antidepressants (TCA). PSM have an uncertain efficacy, carry a risk of dependency, and may cause deleterious side effects. OSM (usually diphenhydramine and doxylamine) are believed to be safer, ...
Source: Cancer Research - September 30, 2014 Category: Cancer & Oncology Authors: Peppone, L. J., Janelsins, M., Friedberg, J., Tejani, M., Kamen, C., Flannery, M., Peoples, A., Atkins, J., Melnik, M., Mustian, K. Tags: Prevention Research Source Type: research

Hypnotic use and fatigue in multiple sclerosis
• Fatigue, insomnia, and hypnotic use are each common in patients with multiple sclerosis (MS).• Products that contain diphenhydramine account for a high proportion of hypnotic use in MS.• Over-the-counter hypnotic use is independently associated with MS-related fatigue. (Source: Sleep Medicine)
Source: Sleep Medicine - September 25, 2014 Category: Sleep Medicine Authors: Tiffany J. Braley, Benjamin M. Segal, Ronald D. Chervin Tags: Original Article Source Type: research

893p * predictors of hypersensitivity reactions (hsrs) in patients receiving carboplatin-based chemotherapy for ovarian cancer
Conclusions: Ovarian cancer patients receiving 8 to 10 cycles of carboplatin-containing chemotherapy and those with a long interval (>12 months) since last receiving carboplatin are at an increased risk of carboplatin-induced HSRs. These patients may be targeted for future prevention therapies.Disclosure: All authors have declared no conflicts of interest. (Source: Annals of Oncology)
Source: Annals of Oncology - September 24, 2014 Category: Cancer & Oncology Authors: Jerzak, K. J., Manshadi, S. D., Ng, P., Maganti, M., McCuaig, J. M., Oza, A. M., Mackay, H. Tags: gynaecological cancers Source Type: research

1532p * the evaluation of paclitaxel hypersensitivity reactions (hsrs) following the discontinuation of prophylactic pre-medications
Conclusions: In patients receiving paclitaxel+platinum regimens or paclitaxel +/- trastuzumab, the discontinuation of pre-medications is a safe and feasible option if a patient has not experienced an HSR during the first or second dose of paclitaxel.Disclosure: All authors have declared no conflicts of interest. (Source: Annals of Oncology)
Source: Annals of Oncology - September 24, 2014 Category: Cancer & Oncology Authors: Meyer, C., Raymond, C., Lee, R., Amir, E., Mackay, H., Oza, A. M., Warr, D., Ng, P. Tags: supportive care Source Type: research

Symptomatic treatment of the cough in whooping cough.
CONCLUSIONS: There is insufficient evidence to draw conclusions about the effectiveness of interventions for the cough in whooping cough. More high-quality trials are needed to assess the effectiveness of potential antitussive treatments in patients with whooping cough. PMID: 25243777 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - September 22, 2014 Category: Journals (General) Authors: Wang K, Bettiol S, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A Tags: Cochrane Database Syst Rev Source Type: research

A viscous lidocaine mouthwash is no better than placebo for improving oral intake in children with painful mouth ulcers
Commentary on: Hopper SM, McCarthy M, Tancharoen C, et al.. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med 2014;63:292–9. Context Ulcerative oral conditions, infectious (herpetic gingivostomatitis, herpangina, hand, foot and mouth disease) and non-infectious (pharyngitis, gingivostomatitis and aphthous), are often observed in children.1 While most conditions are benign, they can be highly painful, impair food intake, and, more specifically, result in dehydration in young children. Aetiological therapies of viral...
Source: Evidence-Based Medicine - September 15, 2014 Category: Internal Medicine Authors: Descroix, V., Coudert, A. E. Tags: Pain (neurology), Dentistry and oral medicine, Ear, nose and throat/otolaryngology Therapeutics Source Type: research

Pre-medications for cetuximab induced infusion reactions – Commentary
We read with great interest the recent work by Touma and colleagues evaluating the role of additional pre-medications to mitigate cetuximab-related hypersensitivity reactions (HSR) [1]. Their results suggest the addition of dexamethasone, albuterol and famotidine to diphenhydramine prior to cetuximab reduces the incidence of overall as well as high-grade HSR. This finding is in agreement with a retrospective analysis of the MABEL trial, which indicated that dexamethasone as a premedication reduced the rate of HSR [2]. (Source: Oral Oncology)
Source: Oral Oncology - September 14, 2014 Category: Cancer & Oncology Authors: Trevor McKibbin, R. Donald Harvey, Nabil F. Saba Tags: Letter to the editor Source Type: research

Electrocardiogram attenuation of QRS complexes in association with Takotsubo syndrome
The interesting case report by Rojas-Marte et al. [1], published ahead of print in the Journal on July 31, 2014, about a 31year-old woman who suffered Takotsubo syndrome (TTS), complicated by cardiac arrest and cardiogenic shock, following an overdose of ibuprofen and diphenhydramine, and was treated successfully with extracorporeal membrane oxygenation, provides me with the opportunity to bring to the attention of the authors a newly described association of TTS with early transient electrocardiogram (ECG) attenuation of the QRS complexes (ATTQRS) [2,3]. (Source: Cardiovascular Revascularization Medicine)
Source: Cardiovascular Revascularization Medicine - September 14, 2014 Category: Cardiology Authors: John E. Madias Source Type: research

The Case Files: Culling through Diagnoses to Get to Rat Bite Fever
By Dyer, Alexandra; Berg, Kenneth MD; King, Andrew MD Rat bite fever (RBF) is a fairly rare illness caused by Streptobacillus moniliformis or Spirillum minus. It can be a devastating and even fatal illness if left undiagnosed or untreated. Despite its name, RBF is not only transmitted by rat bites but also by contact with rat feces, ingestion of rat-contaminated food and water, or simply through direct contact with rats. (Clin Microbiol Rev 2007;20[1]:13; Vet Microbiol 2009;133[3]:211; BMJ Case Rep 2009; Epub Dec 17.) The first documented outbreak in Haverhill, MA, in 1926 was believed to be caused by a pathogen named Have...
Source: The Case Files - September 2, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Diphenhydramine’s Role in Death Investigations: An Examination of Diphenhydramine Prevalence in 2 US Geographical Areas
ConclusionsAs people seek legal alternative drugs to abuse and with the ease of obtaining information via online forums, there is a potential to see an increase in the number of cases involving excessive use of DPH. (Source: The American Journal of Forensic Medicine and Pathology)
Source: The American Journal of Forensic Medicine and Pathology - September 1, 2014 Category: Forensic Medicine Tags: Case Reports Source Type: research

Immediate hypersensitivity reaction following liposomal amphotericin-B (AmBisome) infusion.
We report two patients with kala-azar: one developed breathing difficulties and hypotension followed by shock and the other had facial angioedema with chest tightness during treatment. Both patients were managed with immediate action of injection: adrenaline, diphenhydramine and hydrocortisone. In our experience, AmBisome can cause severe hypersensitivity reactions that warrant proper support and close supervision. PMID: 25139411 [PubMed - as supplied by publisher] (Source: Tropical Doctor)
Source: Tropical Doctor - August 19, 2014 Category: Tropical Medicine Authors: Nath P, Basher A, Harada M, Sarkar S, Selim S, Maude RJ, Noiri E, Faiz A Tags: Trop Doct Source Type: research

Inadvertent Iatrogenic Misuse of Intravenous Diphenhydramine in an Adolescent: Implications for Routine Medication Administration
Journal of Child and Adolescent Psychopharmacology , Vol. 0, No. 0. (Source: Journal of Child and Adolescent Psychopharmacology)
Source: Journal of Child and Adolescent Psychopharmacology - July 30, 2014 Category: Pediatrics Tags: article Source Type: research

The Case Files: CrossFit-Induced Carotid Artery Dissection
By Fox, Alex MD; King, Andrew MD   CrossFit has become a workout phenomenon with more than 5,500 gyms and millions of staunch followers. Developed by Greg Glassman, CrossFit defines itself as “that which optimizes fitness, constantly varied functional movements performed at relatively high intensity.” The craze has been embraced by fitness enthusiasts and weekend warriors alike.   These intense workouts can be dangerous for those with less experience who do not have trainers to help ease them into the routine. A 2005 New York Times article, “Getting Fit, Even If It Kills You,” criticized CrossFit for placing emph...
Source: The Case Files - July 8, 2014 Category: Emergency Medicine Tags: Blog Posts Source Type: research

Scavenger hunt: A creative teaching strategy to introduce pharmacological concepts and ethical concerns
Abstract: The sheer volume and number of errors in medication administration obliges nursing educators to facilitate a higher level of student understanding in foundational pharmacological concepts. The focus of this manuscript was the use of a faculty created teaching strategy to introduce foundational pharmacological concepts and ethical concerns in an undergraduate nursing pharmacology course. The use of the Scavenger Hunt facilitated active learning and student engagement as students were responsible for and active in their own learning.The intent of the Scavenger Hunt was to introduce students to complex pharmacologic...
Source: Teaching and Learning in Nursing - July 1, 2014 Category: Nursing Authors: Elizabeth A. Tinnon Source Type: research

Olfactory stimulatory with grapefruit and lavender oils change autonomic nerve activity and physiological function.
Abstract This review summarizes the effects of olfactory stimulation with grapefruit and lavender oils on autonomic nerve activity and physiological function. Olfactory stimulation with the scent of grapefruit oil (GFO) increases the activity of sympathetic nerves that innervate white and brown adipose tissues, the adrenal glands, and the kidneys, decreases the activity of the gastric vagal nerve in rats and mice. This results in an increase in lipolysis, thermogenesis, and blood pressure, and a decrease in food intake. Olfactory stimulation with the scent of lavender oil (LVO) elicits the opposite changes in nerve...
Source: Autonomic Neuroscience - June 25, 2014 Category: Neuroscience Authors: Nagai K, Niijima A, Horii Y, Shen J, Tanida M Tags: Auton Neurosci Source Type: research

Novel Use of Dexmedetomidine for the Treatment of Anticholinergic Toxidrome.
We report the case of an adolescent with anticholinergic toxidrome from diphenhydramine overdose, whose symptoms were treated with a novel application of dexmedetomidine. CASE REPORT: A 13-year-old female developed an anticholinergic toxidrome after intentionally ingesting 9.5 mg/kg of diphenhydramine. Despite routine supportive therapies, to include appropriate doses of lorazepam, she continued to have significant agitation, psychosis, and hallucinations. A dexmedetomidine infusion was started to aid in the treatment of her agitation and psychosis with marked improvement of her symptoms. DISCUSSION: Using dexmede...
Source: Journal of Medical Toxicology - June 19, 2014 Category: Toxicology Authors: Walker A, Delle Donne A, Douglas E, Spicer K, Pluim T Tags: J Med Toxicol Source Type: research

Honey for acute cough in children
Abstract BackgroundCough causes concern for parents and is a major cause of outpatient visits. It can impact on quality of life, cause anxiety and affect sleep in parents and children. Several remedies, including honey, have been used to alleviate cough symptoms. ObjectivesTo evaluate the effectiveness of honey for acute cough in children in ambulatory settings. Search methodsWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2011) which contains the Cochrane Acute Respiratory Infections Group's Specialised Register; MEDLINE (1950 to December week 4, 2011); EMBASE (1990 ...
Source: Evidence-Based Child Health: A Cochrane Review Journal - June 16, 2014 Category: Pediatrics Authors: Olabisi Oduwole, Martin M Meremikwu, Angela Oyo‐Ita, Ekong E Udoh Tags: Intervention Review Source Type: research

Effects of Leukoreduction and Premedication With Acetaminophen and Diphenhydramine in Minimizing Febrile Nonhemolytic Transfusion Reactions and Allergic Transfusion Reactions During and After Blood Product Administration: A Literature Review With Recommendations for Practice
Transfusion-related reactions cause unwanted interruptions in blood-product administration and potential complications for patients. The most common reactions are febrile nonhemolytic transfusion reactions (FNHTRs) and allergic transfusion reactions (ATRs). The presence of leukocytes in blood products has been associated with these reactions, and efficacy of leukoreduction in minimizing FNHTRs and ATRs has recently been investigated. In addition, premedication with acetaminophen and diphenhydramine is the most widely used practice in minimizing FNHTRs and ATRs, yet the benefit of this is not supported by research. The aim ...
Source: Journal of Pediatric Oncology Nursing - June 13, 2014 Category: Nursing Authors: Duran, J., Siddique, S., Cleary, M. Tags: Articles Source Type: research