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Benylin dependence, metabolic acidosis and hyperglycaemia
Postgraduate Medical Journal
|July 1, 1987
Summary
Daily use of a cough mixture containing diphenhydramine can lead to serious health issues. Patients may experience confusion, metabolic acidosis, and hyperglycemia from prolonged use of expectorants.
Area of Science:
- Pharmacology
- Toxicology
- Internal Medicine
Background:
- Diphenhydramine-containing cough suppressants are widely available.
- Chronic overuse of over-the-counter medications can lead to adverse effects.
- Understanding the toxicity profile of common pharmaceutical agents is crucial.
Observation:
- A patient consumed large quantities of a proprietary cough mixture (Benylin expectorant) daily for months.
- The mixture contained diphenhydramine, ammonium chloride, and sodium citrate.
- The patient presented with acute confusion and metabolic derangements.
Findings:
- The patient exhibited marked metabolic acidosis.
- Non-ketotic hyperglycemia was a significant clinical finding.
- Diphenhydramine toxicity is implicated in the observed clinical presentation.
Implications:
- This case highlights the potential dangers of chronic, high-dose diphenhydramine consumption.
- Clinicians should consider medication overuse in patients presenting with unexplained metabolic disturbances.
- Raising awareness about the risks associated with common cough and cold remedies is essential.