PDF(Pubmed)
Abstract：
From 2019 to 2020, antihistamines were found in 15% of all US drug overdose deaths, often co-administered with fentanyl, with 3.6% of overdose deaths due to antihistamines alone. The most common antihistamine found in all these reported deaths is diphenhydramine, a ubiquitous, over-the-counter and clinically important medication. Currently, there is no antidote for diphenhydramine overdose. This review summarizes the adverse health effects and current emergency medicine treatments for diphenhydramine. Several emergency medicine case reports are reviewed, and the efficacy and outcomes of a variety of treatments are compared. The treatments reviewed include the more traditional antihistamine overdose therapeutics physostigmine and sodium bicarbonate, as well as newer ones such as donepezil, dexmedetomidine, and lipid emulsion therapy. We conclude that more study is needed to determine the ideal therapeutic approach to treating antihistamine overdoses.
摘要：
从2019年到2020年，在美国所有药物过量死亡的15%中发现了抗组胺药，经常与芬太尼共同给药，3.6%的过量死亡是由于单独的抗组胺药。在所有这些报告的死亡中发现的最常见的抗组胺药是苯海拉明，一个无处不在的，非处方药和临床重要药物。目前,苯海拉明过量没有解毒剂.这篇综述总结了苯海拉明的不良健康影响和当前的急诊医学治疗方法。回顾了几例急诊医学病例报告，并比较了各种治疗方法的疗效和结果。审查的治疗方法包括更传统的抗组胺药过量治疗毒扁豆碱和碳酸氢钠，以及较新的如多奈哌齐，右美托咪定,和脂肪乳剂治疗。我们得出的结论是，需要更多的研究来确定治疗抗组胺药过量的理想治疗方法。
