Benadryl and Resp Patients

[chenoaspirit, ASN, RN]

Hi. This may seem like a stupid question. I had a patient who had lung cancer and his O2 sats were LOW. He was on 100% NRB. He was uncomfortable, restless, and unable to sleep. The family requested IV Benadryl. Now, I was always told that Benadry can sedate to the point of depressed resp. I was scared to call doc and request it. I didnt want to speed up his death. I did call the doc though and he ordered Haldol. When is Benadryl not recommended? I was also told that cardiac patients shouldnt take Benadryl. I have been told things by docs, then told the opposite by other docs. I know this may sound like a dumb question, but I desperately need to know. Thanks.

[jbanks]

I work in psych but am just a nursing student so don't take my word for it, but many geriatric patients that are agitated respond well to benydral- better than most of the other meds. It is not supposed to depress their system as much. Haldol can sometimes have paradoxical effects on the elderly causing more agitation and even akathesia. Again, this is just what I 've learned from working in psych and not as a practitioner.

[Lacie, BSN, RN]

Personally after 24 years in CC I have no problem in giving Benedryl to a cardiac pt for rest. If anything it's the Haldol I would hate to give. I very rarely had good luck with Haldol as to me it was just a doc's/nurses easy escape for a confused pt. Agreed sometimes it can be effective so dont flame for for the last sentence. Benedryl is less caustic in relation to causing sedation/increased confusion then Haldol. If I could have avoided Haldol in most cases I did.

[NRSKarenRN, BSN, RN]

warnings

antihistamines should be used with considerable caution in patients with narrow-angle glaucoma, stenosing peptic ulcer, pyloroduodenal obstruction, symptomatic prostatic hypertrophy, or bladder-neck obstruction. not recommended for children with chronic lung disease or glaucoma.

topical:

for external use only. do not use on chicken pox, measles or extensive areas of skin. if condition worsens or persists for more than 7 days, consult a physician. do not use other drugs containing diphenhydramine while using this product.

children:

in infants and children, especially, antihistamines in overdosage may cause hallucinations, convulsions, or death. as in adults, antihistamines may diminish mental alertness in children. in the young child, particularly, they may produce excitation.

geriatrics (approximately 60 years or older):

antihistamines are more likely to cause dizziness, sedation and hypotension in elderly patients.

http://www.mentalhealth.com/drug/p30-b01.html

use benadryl cautiously if you have a history of asthma or other chronic lung disease, an over-active thyroid, high blood pressure, or heart disease.

medlineplus drug information: antihistamines (systemic)