bǎi fú níng
2 English referenceBufferin analgesic>
3 GeneralBufferin is the active metabolite of fenacidin, an antipyretic and analgesic drug, a white crystalline or crystalline powder; odorless, mildly flavored, with a slight taste. powder; odorless, slightly bitter taste. Its analgesic mechanism is not very clear, may be through the inhibition of the central nervous system in the synthesis of prostaglandins and block the impulse of the nociceptive nerve endings and produce analgesic effect. It has good antipyretic and analgesic effects, and has no effect on platelets and coagulation mechanism. Adult poisoning blood concentration value is 15mg/dl. 150mg/kg for children, mainly damage to the liver, there can be kidney and blood system changes, occasionally allergic reactions.
4 Paracetamol Pharmacopoeia standard 4.1 Name 4.1.1 Chinese nameParacetamol
4.1.2 Chinese pinyinDuiyixian'anjifen
4.1.3 English name
Paracetamol
4.2 Structural formula 4.3 Molecular formula and molecular weightC8H9NO2? 151.16
4.4 Source (name), content (potency)This product is 4'hydroxyacetanilide. Calculated according to the dry product, containing C8H9NO2 should be 98.0% to 102.0%.
4.5 PropertiesThis product is white crystal or crystalline powder; odorless, slightly bitter taste.
The product is soluble in hot water or ethanol, soluble in acetone, slightly soluble in water.
4.5.1 Melting pointThe melting point of this product (2010 version of Pharmacopoeia II Appendix VI C) is 168-172 ℃.
4.6 Identification(1) The aqueous solution of this product with ferric chloride test solution, that is, a blue-purple color.
(2) take about 0.1g of this product, add 5ml of dilute hydrochloric acid, heat in a water bath for 40 minutes, cool; take 0.5ml, add 5 drops of sodium nitrite test solution, shake well, dilute with 3ml of water, add the basic β-naphthol test solution of 2ml, shake, that is, show red.
(3) The infrared light absorption pattern of this product should be consistent with the pattern of the control (Infrared Spectrum Collection of Pharmaceuticals, Figure 131).
4.7 Check 4.7.1 AcidityTake 0.10g of this product, add 10ml of water to dissolve, according to the law (2010 version of the Pharmacopoeia II Appendix VI H), the pH value should be 5.5-6.5.
4.7.2 Ethanol solution clarification and colorTake 1.0g of this product, add 10ml of ethanol to dissolve, the solution should be clarified and colorless; such as showing turbidity, with the No. 1 turbidity standard solution (2010 version). Turbidity standard solution (2010 version of the Pharmacopoeia II Appendix IX B), shall not be thicker; if color, and brown-red No. 2 or orange-red No. 2 standard colorimetric solution (2010 version of the Pharmacopoeia II Appendix IX A, the first method), shall not be darker.
4.7.3 ChlorideTake 2.0g of this product, add 100ml of water, heat to dissolve, cooling, filtration, 25ml of filtrate, according to the law (2010 version of the Pharmacopoeia, Part II, Appendix VIII A), and compared with the standard sodium chloride solution made of 5.0ml of the control solution, shall not be more concentrated (0.01%).
4.7.4 SulfateTake 25 ml of the filtrate remaining under chloride, check according to the law (2010 version of Pharmacopoeia II Appendix VIII B), and compare it with the control solution made of 1.0 ml of standard potassium sulfate solution, and it shall not be more concentrated (0.02%).
4.7.5 P-aminophenol and related substancesPro-use of new production. Take the appropriate amount of this product, precision weighing, add solvent [methanol - water (4:6)] to make a solution containing about 20 mg per 1 ml, as a test solution; another p-aminophenol control and Benadryl control appropriate amount, precision weighing, add the above solvent to dissolve and make a mixture containing about 1 μg of p-aminophenol and Benadryl 20 μg per 1 ml of solution, as a control solution. Solution. Tested according to high performance liquid chromatography (2010 version of Pharmacopoeia II Appendix V D). Using octylsilane silica bonded silica gel as filler; phosphate buffer (take 8.95 g of disodium hydrogen phosphate, 3.9 g of sodium dihydrogen phosphate, dissolve with water to 1000 ml, add 10% tetrabutylammonium hydroxide solution 12 ml) methanol (90:10) as the mobile phase; detection wavelength of 245 nm; the column temperature of 40 ℃; the theoretical plate number of the peak of Peptonine is not less than 2,000, and the peak of p-aminophenol and the peak of Peptonine are not less than 2,000, and the peak of p-amino phenol and the peak of p-amino phenol are not less than 2,000. The theoretical plate number should not be less than 2000 according to the peak of p-aminophenol, and the separation between the peak of p-aminophenol and the peak of Benadryl should meet the requirements. Take 20 μl of the control solution, inject into the liquid chromatograph, adjust the detection sensitivity, so that the peak height of the p-aminophenol peak is about 10% of the full scale, and then take a precise amount of the test solution and the control solution of 20 μl, respectively, inject into the liquid chromatograph, and record the chromatograms to the retention time of the peaks of the main components 4 times; if there is a chromatogram in the chromatogram of the test solution that has a chromatographic peak that is identical with the retention time of the p-aminophenol peaks in the control solution, then the peaks should be separated by peaks according to external standard method, and the peaks should be separated by peaks according to the method. If there is a peak in the chromatogram of the test solution with the same retention time as the p-aminophenol peak in the control solution, calculated by peak area according to the external standard method, the p-aminophenol shall not be more than 0.005%; the peak area of other impurities shall not be greater than that of the peak area of the paxil in the control solution (0.1%); the total amount of impurities shall not be more than 0.5%.
4.7.6 p-ChlorobenzeneacetamidePro-use new system. Take p-aminophenol and related substances under the test solution as a test solution; another p-chlorobenzeneacetamide control and Benadryl control appropriate amount, precision weighing, add solvent [methanol and water (4:6)] to dissolve and make a mixture of p-chlorobenzeneacetamide 1ug and Benadryl 20ug per 1ml [1], as a control solution. Tested according to high performance liquid chromatography (2010 version of Pharmacopoeia II Appendix V D). Using octylsilane silane bonded silica gel as filler; phosphate buffer (take 8.95g of disodium hydrogen phosphate, 3.9g of sodium dihydrogen phosphate, dissolve with water to 1000ml, add 10% tetrabutylammonium hydroxide 12ml) methanol (60:40) as the mobile phase; detection wavelength of 245nm; the column temperature of 40 ℃; the theoretical number of plates according to the peak of Pepstatin is not less than 2000, and the separation of the peaks of P-chlorophenylacetamide and P-chlorophenylacetamide is not less than 2,000. The theoretical plate number should not be less than 2000 according to the peak of p-chlorobenzeneacetamide, and the separation between the peak of p-chlorobenzeneacetamide and the peak of Benzoylbenzene should meet the requirements. Take 20μl of the control solution, inject into the liquid chromatograph, adjust the detection sensitivity, so that the peak height of the p-chlorobenzeneacetamide peak is about 10% of the full scale, and then take a precise amount of 20μl of the test solution and the control solution, respectively, injected into the liquid chromatograph, and record the chromatograms; according to the external standard method with the calculation of the peak area, the peak area of the p-chlorobenzeneacetamide shall not be more than 0.005%.
4.7.7 Loss on dryingTake the product, dry at 105 ℃ until constant weight, weight loss should not be more than 0.5% (2010 version of the Pharmacopoeia II Appendix VIII L).
4.7.8 Residue from incinerationNot more than 0.1% (2010 version of the Pharmacopoeia II Appendix VIII N).
4.7.9 Heavy metalsTake 1.0 g of this product, add 20 ml of water, heat in a water bath to dissolve, cool, filter, take the filtrate and acetate buffer (pH 3.5) 2 ml with the appropriate amount of water to make 25 ml, according to the law (2010 version of the Pharmacopoeia, Appendix VIII, Part H, H, the first method), the content of heavy metals shall not be more than 10 parts per million.
4.8 Content DeterminationTake about 40mg of this product, precision weighing, placed in a 250ml measuring flask, add 0.4% sodium hydroxide solution 50ml dissolved, add water to the scale, shaking, precision measurement of 5ml, placed in a 100ml measuring flask, add 0.4% sodium hydroxide solution 10ml, add water to the scale, shaking, according to the UV-visible spectrophotometric photometric method (2010 version of the Pharmacopoeia II Appendix VIII H first method). Photometric method (2010 version of the Pharmacopoeia II Appendix Ⅳ A), at the wavelength of 257nm to determine the absorbance, according to the absorption coefficient of C8H9NO2 () is 715, it is obtained.
4.9 CategoryAntipyretic and analgesic.
4.10 StorageKeep sealed.
4.11 Preparation(1) Benadryl tablets? (2) Bupropion chewable tablets? (3) Bupropion effervescent tablets? (4) Benadryl injection? (5) Benadryl suppositories (6) Benadryl capsules? (7) Benadryl granules (8) Benadryl drops? (9) Benadryl Gel
4.12 EditionsChinese Pharmacopoeia of the People's Republic of China, 2010 Edition
5 Instructions for Benadryl 5.1 Name of the drugBenadryl
5.2 English namesParacetamol ,Acetaminophen,Fortolin,Panodol, Snaplets, Sufferin, Tylenol
5.3 Alias of ParacetamolParacetamol; Acetaminophen; Acetaminophen; Acetaminophen; Benadryl; Tylenol; Hitachi Ching; One-Drop Ching; Antipyretic; Saiyenin; Tylenol Analgesic Tablets; Yasda; Snap; Acetaminophen
5.4 ClassificationNervous system drugs > Antipyretic Analgesics
5.5 Dosage forms1. Tablets: .0.1g, 0.3g, 0.5g;
2. Chewable tablets (acetaminophen chewable tablets): 160mg;
3. Membrane tablets: 160mg;
4. Controlled release tablets: 650mg;
5. Granules: 160mg;
6. .Effervescent granules: 0.1g, 0.5g;
7.Oral solution: 32mg/ml;
8.Drops: 100mg (1ml);
9.Syrup: 50mg (1ml);
10.Anjia fever syrup: 24mg (1ml);
11.Pediatric fever-reducing bolus: 125mg, 300mg.
12. Compound preparations: (1) Compound Pepcid tablets: each tablet contains Pepcid 0.126g, Aspirin 0.23g, Caffeine 0.03g; (2) Acetaminophen tablets (film-coated tablets): 0.5g; (3) Saridon tablets: each tablet contains Pepcid 250mg, Isobuproventolin
5.6 Pharmacological effects of BenadrylBenadryl is an acetanilide antipyretic and analgesic, which is the metabolite of finasteride in vivo, and the mechanism of its analgesic is not very clear, probably through the inhibition of the synthesis of prostaglandins in the central nervous system (including the inhibition of prostaglandin synthetase) as well as the blockade of impulses of nociceptive nerve endings and the production of analgesic effects. The blockade of impulses to nociceptive nerve endings may be related to the inhibition of the synthesis of prostaglandins or other substances (e.g., 5-hydroxytryptamine, bradykinin, etc.) that can sensitize nociceptive receptors. Benadryl may have an antipyretic effect by affecting the thermoregulatory center in the inferior colliculus, possibly related to the inhibition of prostaglandin synthesis in the inferior colliculus. The antipyretic effect of bupropion is strong, similar to aspirin, and more durable, but the analgesic and anti-inflammatory effect is weaker, and the lower dosage is ineffective in rheumatic diseases. This is because bupropion inhibits the synthesis and release of prostaglandins in the dorsal thalamus, while inhibiting the synthesis and release of peripheral prostaglandins is weak. Therefore, Benadryl is not a substitute for aspirin or other non-steroidal anti-inflammatory drugs in the treatment of all types of arthritis, but it can be used in cases of allergy, intolerance or inappropriateness of aspirin application, such as chickenpox, hemophilia and other bleeding disorders (including the application of anticoagulant therapy), as well as peptic ulcer, gastritis and so on. Treatment with Benadryl and, if necessary, other therapies must be applied to relieve the cause of pain or fever. Aspirin drugs (e.g. aspirin, Benadryl, ibuprofen, etc.) have a protective effect against the development of cataracts.
5.7 Pharmacokinetics of BenadrylBenadryl is rapidly and completely absorbed orally, evenly distributed in body fluids, and can reach its peak value in 0.5-2 h after oral administration, with the effect maintained for 3-4 h. About 25% of it is bound to plasma proteins, and protein binding is not evident in small quantities (blood concentration less than 60 μg/ml); a large number of it or a poisonous amount of it is bound to proteins with a high binding rate, up to 43%. Bacitracin is 90% to 95% metabolized in the liver, about 60% is bound to glucuronic acid, and the rest is bound to sulfuric acid and cysteine. The intermediate metabolites have toxic effects on the liver. t1/2 is 2~3h, which can be prolonged 1~2 times in hepatic decompensation, and also prolonged in the elderly and neonates, while shortened in pediatrics. Benadryl is excreted from the kidneys mainly as glucuronide conjugate, and about 3% is excreted in urine in its original form within 24h. Under normal conditions, it can be detoxified by glutathione binding in the liver. In case of overdose of Benadryl, glutathione stores are depleted and the metabolite binds to hepatocyte macromolecules, causing hepatic necrosis.
5.8 Indications for Benadryl1. For the treatment of colds and fever.
2. Arthralgia, neuralgia, headache, migraine, cancer pain and postoperative pain relief.
3. Particularly suitable for patients who are allergic to or intolerant of aspirin, such as hemophilia, bleeding disorders, patients treated with anticoagulants, patients with peptic ulcer and gastritis.
5.9 Contraindications to Benadryl1. Hypersensitivity to Benadryl is contraindicated.
2. Contraindicated in neonates.
5.10 Precautions1. (1) Liver disease or viral hepatitis: Benadryl has an increased risk of hepatotoxicity, so the risk of adverse reactions is increased with liver disease. (2) Renal insufficiency: it can be used occasionally, but there is a danger of increasing renal toxicity if applied in large quantities for a long time. (3) Patients with severe heart and lung diseases: the use of Benadryl should be strictly controlled. (4) Alcoholics. (5) Glucose 6-phosphate dehydrogenase 6-phosphate dehydrogenase deficiency 6-phosphate dehydrogenase deficiency patients: this kind of patients to make Benadryl has been reported to occur hemolysis. (6) Pregnant women.
2. The effect of the drug on children: children under 3 years of age and newborns should be avoided due to underdevelopment of liver and kidney function.
3. Effects of drugs on pregnancy: Benadryl can pass through the placenta, so pregnant women should consider the possible adverse effects on the fetus.
4. The effect of drugs on test values or diagnosis: (1) blood glucose measurement: the application of glucose oxidase / peroxidase method can be false low values, while the use of hexokinase / 6-phosphate dehydrogenase method has no effect. (2) Serum uric acid: false high values can be obtained with the phosphotungstic acid method. (3) Urinary 5-hydroxyindoleacetic acid (5-HIAA): false-positive results can be obtained when applying nitrosonaphthol reagent for qualitative screening test, while quantitative test is not affected. (4) Liver function test: when a large dose is applied (more than 8-10g) or when a smaller dose is applied for a long period of time (more than 3-5g per day), the prothrombinogen time, serum bilirubin concentration, serum lactate dehydrogenase concentration, and serum aminotransferase can be increased. (5) False-positive results can be obtained when using the YSI glucose analyzer.
5. Items that should be checked or monitored before, during, and after administration: liver and kidney function should be checked before administration, and regular rechecks should be performed on long-term, high-dose patients (including blood, liver and kidney function, etc.).
6. Overdose reaction: (1) overdose (including toxicity), can quickly appear pale, lack of appetite, nausea, vomiting, stomach pain or stomach cramps, diarrhea, fear of food, sweating, and other symptoms, and can last for 24 h. In 1 ~ 4 days can appear abdominal pain, hepatomegaly and tenderness, aminotransferase elevation and jaundice. Obvious liver failure (fulminant hepatic failure) may appear on the 4th to 6th day, manifested by hepatic encephalopathy (psychosis, impaired consciousness, agitation, somnolence), fluttering tremor, convulsions, respiratory depression, coma and other symptoms of cerebral edema, as well as coagulation disorders, gastrointestinal hemorrhage, diffuse intravascular coagulation, hypoglycemia, acidosis, cardiac arrhythmia, circulatory failure, and necrosis of renal tubules until death. (2) Some patients have atypical presentations with only abdominal pain, metabolic acidosis or coma, hyperventilation, and respiratory depression. Renal failure occurs in about 12% of patients who overdose, but is not always accompanied by hepatic failure. (3) Myocardial damage has been reported after overdose.
7. Treatment of overdose: (1) vomiting and gastric lavage to reduce drug absorption, after gastric lavage ear with medicinal charcoal adsorption of drugs, but should be noted that medicinal charcoal also affects the absorption and efficacy of oral acetylcysteine (acid). (2) Acetylcysteine should be used as early as possible, and is most effective when used within 10-12h after overdose. Start with 140mg/kg orally, then use 17 times at a dose of 70mg/kg every 4 hours***; in severe cases, the drug can be dissolved in 5% dextrose injection 20ml spit for intravenous administration. (3) The use of hemodialysis or hemoperfusion, if acetylcysteine fails to be administered within 24 h of an overdose of Benadryl, may be beneficial in removing Benadryl from the circulation, but the effectiveness of this treatment in preventing its hepatotoxicity is unknown. (4) Monitor plasma thymine concentrations at least 4 h after overdose; premature determinations are not helpful in reliably assessing potential hepatotoxicity. Liver function tests, including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), prothrombinogen time, and bilirubin quantification, should be performed every 24 hours for at least 96 h. If no abnormal values are seen within 96 h, no further tests are necessary. Renal and cardiac function tests should be performed according to clinical needs. (5) Supportive therapy: maintenance of water-electrolyte balance, correction of hypoglycemia, supplementation of vitamin K11 (such as prothrombin time ratio greater than 1.5) or use of fresh frozen plasma, concentrated coagulation factors (such as prothrombin time ratio greater than 3.0).
5.11 Adverse Reactions to Benadryl1. The gastrointestinal *** effect of Benadryl is small, and short-term use does not cause gastrointestinal bleeding. However, several cases of hepatotoxicity have been reported with the use of Benadryl, even causing liver failure and hepatic necrosis. Alcohol abuse may exacerbate hepatotoxicity.
2. Urological system: long-term high-dose administration of Benadryl can cause nephropathy, including renal *** necrotizing renal failure, especially in renal hypoplasia, renal colic or acute renal failure (oliguria, uremia). Renal failure may also occur secondary to hepatic impairment caused by Bacitracin.
3. Hematologic: Rare hematologic adverse reactions have been reported, and thrombocytopenia (including immune thrombocytopenia) has been reported occasionally. Other rare hematological adverse reactions are hemolytic anemia, granulocyte deficiency, pancytopenia, plasmacytosis, thrombocytosis, chronic granulocytic leukemia and chronic lymphocytic leukemia. Compared with aspirin, Pepcid has little effect on bleeding time and platelet aggregation time.
4. Endocrine / metabolism: foreign animal experiments found that high doses of Benadryl can inhibit thyroid function and *** generation, but it is not yet certain what the relationship with the clinical. There are reports of hypothermia in foreign countries, and metabolic acidosis has been reported in overdose. Poisonous doses can cause hypophosphatemia and hypoglycemia, and there have also been reports of transient hyperglycemia.
5. Skin: urticaria, fixed drug rash, occasional dermatitis with itching. There are foreign reports of vascular purpura, acute generalized herpes-like impetigo, ***-like maculopapular rash. Rarely toxic epidermal necrolysis.
6. Skeletal muscle: foreign use of Benadryl as a stimulation test has been reported to cause rhabdomyolysis.
7. Allergic reactions are rare.
8. No carcinogenicity has been reported.
5.12 Usage and dosage of Benadryl1.0.5-1.0g, 3-4 times a day.
2.Children's dosage: 6 to 12 years old, 0.25 to 0.5g per oral dose, 3 to 4 times a day. children under 6 years old are not used.
3. Suppositories can also be used in adults and children.
5.13 Drug interactions1. Benadryl can inhibit the metabolism of vinpocetine or interfere with clot formation, thus enhancing the anticoagulant effect of vinpocetine.
2. Benadryl may inhibit the metabolism of warfarin or block clot-contracting factor formation, thereby increasing the risk of warfarin-induced bleeding.
3. When diflunisal is used in combination with buspirone, the plasma concentration of buspirone rises by about 50%, and this significant increase in concentration has been reported to cause hepatotoxicity. The blood concentration of diflunisal is unchanged.
4. The combination of fenoldopam and Benadryl resulted in an increase in fenoldopam serum concentrations of 30% (short-term combination) and 70% (long-term combination); an increase in fenoldopam's area under the curve (AUC) of 50% (short-term combination) and 66% (long-term combination); and a decrease in fenoldopam metabolite levels and AUC. No adverse clinical effects have been reported with short-term co-administration.
5. Methylenedioxymethamphetamine inhibits the formation of the glucosinolate conjugate of Benadryl, increasing the risk of Benadryl toxicity.
6. When sulfinpyrazone is used in combination with Benadryl, the metabolism of Benadryl is increased and the toxicity to the liver is increased.
7. Benztropine promotes the clearance of lamotrigine from the blood, so the efficacy of lamotrigine is reduced.
8. Fosphenytoin and phenytoin sodium can increase the metabolism of Benadryl in the liver, so that the efficacy of Benadryl decreases and hepatotoxicity increases.
9. Pepcidin decreases glutathione, which is excreted from the body by binding to glutathione, so the renal clearance rate of pepcidin decreases when the two are used together.
10. Carbamazepine is a hepatic enzyme inducer, and high doses and frequent use in combination with bupropion can lead to enhanced metabolism of bupropion and an increase in hepatotoxic products.
11. Kaurenzamide can reduce the absorption of Benadryl, so that the efficacy of Benadryl is weakened.
12. Tizanidine (muscarinic) delays the peak time of oral administration of buspirone, but the clinical significance is unknown.
13. Isoniazid increases the hepatotoxicity of buspirone.
14. Benztropine may alter the pharmacokinetics of chloramphenicol (specific effects have been reported variably). The combination of the two may increase the toxicity of chloramphenicol with vomiting, hypotension, and hypothermia.
15. When combined with the antiviral drug zidovudine, concomitant use should be avoided because the two drugs may decrease each other's binding to glucuronide and decrease clearance, thereby increasing toxicity.
16. Antacids can significantly delay the time to peak blood concentration of Benadryl, but have no effect on the mean peak plasma concentration, maximum peak plasma concentration and half-life of Benadryl.
17. The combination of zolmitriptan and buspirone resulted in a mild increase in the plasma concentration of the former, but it was not clinically significant.
18. Pepcid can increase the plasma concentration of ethinyl estradiol, which can be reduced by oral contraceptives.
19.When combined with aspirin, other salicylate preparations or other non-steroidal anti-inflammatory drugs in large quantities over a long period of time (e.g., when the cumulative dosage reaches 1,000 g per year and is applied for more than 3 years), it can markedly increase toxicity to the kidneys (including renal *** necrosis, kidney and bladder tumors, etc.).
20. When combined with antihypertensive drugs (such as atenolol), there is no significant change in the antihypertensive effect.
21. Hepatotoxicity is greater in chronic alcoholics than in non-alcoholics with overdose of Benadryl, resulting in greater production of toxic metabolites of Benadryl.
22. Food slows the absorption of Benztropine, resulting in lower peak concentrations.
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5.14 Expert ReviewPepcid is strong in antipyretic and analgesic effects but weak in anti-inflammatory and anti-rheumatic effects. On the gastrointestinal tract *** small, on platelets and coagulation mechanism has less impact. Now there are a variety of clinical compound preparations, widely used in antipyretic and analgesic treatment.
6 Bupropion poisoningBupropion (paracetamol) is the active metabolite of non-narcotics, has a good antipyretic and analgesic effect, has no effect on platelets and coagulation mechanism. The drug reaches peak blood concentration 0.5~2h after oral administration, with plasma protein binding rate of 25%~50%. After a large number of intake can be delayed to 4h, 90% by hepatic metabolism, <5% in its original form by urinary excretion. Plasma half-life 1 ~ 3h, after overdose is prolonged, >12h suggests the possibility of hepatic encephalopathy. The usual amount of this drug oral 0.3 ~ 0.6g / times, 2 ~ 3 / d. Adult poisoning amount of 7.5g, lethal amount of 5 ~ 20g, poisoning blood concentration value of 15mg / dl, lethal blood concentration value of 150mg / dl. Children poisoning amount of 150mg / kg. Mainly damage to the liver, there can be renal and hematological changes, and occasionally allergic reactions. [2]
6.1 Clinical manifestations[2]
1. Adverse reactions? Fewer, there may be nausea, vomiting, sweating, abdominal pain and pallor, etc. Occasionally, platelet and leukopenia, hemolytic anemia and other allergic reactions, occasionally urticaria, dermatitis, bronchospasm and so on.
2. Acute poisoning? Mainly cause liver and kidney damage mainly.
(1) liver damage: manifested as lack of appetite, nausea, vomiting, right upper abdominal tenderness, jaundice, elevated blood bilirubin, aminotransferase, prolongation of prothrombinogen time, the severe cases can occur hepatic encephalopathy, confusion, inattentiveness and other mental symptoms.
(2) Kidney damage: there can be proteinuria, tubular urine, hematuria, oliguria, anuria and so on.
3. Laboratory tests
(1) Detecting the concentration of drugs in plasma can help determine the diagnosis and judge the prognosis.
(2) Detection of liver function and prothrombin time, etc..
6.2 TreatmentThe main points of the treatment of Benadryl poisoning are[3]:
1. Induce vomiting for overdose, give 0.45% saline gastric lavage, and then magnesium sulfate for diarrhea.
2. Apply antidote, acetylcysteine 140mg/kg, dissolved in 5% dextrose solution 300ml IV, and then 70mg/kg every 4h, until 72h.
3. Early, short course, adequate application of glucocorticoids, such as hydrocortisone, dexamethasone.
4. According to the severity of liver and kidney damage, hemodialysis, hemoperfusion and blood exchange can be taken to remove the poison.