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{
    "pk": 8476,
    "title": "Diphenhydramine Overdose with Intraventricular Conduction Delay Treated with Hypertonic Sodium Bicarbonate  and IV Lipid Emulsion",
    "subtitle": null,
    "abstract": "Diphenhydramine toxicity commonly manifests with antimuscarinic features, including dry mucous membranes, tachycardia, urinary retention, mydriasis, tachycardia, and encephalopathy. Severe toxicity can include seizures and intraventricular conduction delay. We present here a case of a 23-year-old male presenting with recurrent seizures, hypotension and wide complex tachycardia who had worsening toxicity despite treatment with sodium bicarbonate. The patient was ultimately treated with intravenous lipid emulsion therapy that was temporally associated with improvement in the QRS duration. We also review the current literature that supports lipid use in refractory diphenhydramine toxicity. [West J Emerg Med. 2014;15(7):–0.]",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution-NonCommercial  4.0",
        "short_name": "CC BY-NC 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNonCommercial — You may not use the material for commercial purposes.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by-nc/4.0"
    },
    "keywords": [
        {
            "word": "Diphenhydramine, lipid, overdose, intraventricular conduction delay, intralipid"
        }
    ],
    "section": "Diagnostic Acumen",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9rt5529p",
    "frozenauthors": [
        {
            "first_name": "Amin",
            "middle_name": "",
            "last_name": "Abdi",
            "name_suffix": "",
            "institution": "University of Southern California, Department of Emergency Medicine, Los Angeles, California",
            "department": "None"
        },
        {
            "first_name": "Emily",
            "middle_name": "",
            "last_name": "Rose",
            "name_suffix": "",
            "institution": "University of Southern California, Department of Emergency Medicine, Los Angeles, California; Department of Pediatrics.  University of Southern California. Los Angeles, CA",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "",
            "last_name": "Levine",
            "name_suffix": "",
            "institution": "University of Southern California, Department of Emergency Medicine, Los Angeles, California",
            "department": "None"
        }
    ],
    "date_submitted": "2014-08-05T00:47:12Z",
    "date_accepted": "2014-08-05T00:47:12Z",
    "date_published": "2014-09-19T20:14:44Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/8476/galley/4894/download/"
        }
    ]
}