Diphenhydramine as a topical ocular anesthetic.

OBJECTIVE: To determine whether 5% diphenhydramine solution has an anesthetic effect when administered topically to rabbit corneas. DESIGN: Experimental study. PARTICIPANTS: Twenty white New Zealand rabbits. METHODS: Twenty rabbits at the University of Arkansas for Medical Sciences received 1 drop of 5% diphenhydramine solution in the left eye and 1 drop of balanced salt solution in the right eye. Corneal sensation was then measured with a Cochet-Bonnet esthesiometer at 30-, 60-, and 90-minute intervals. Rabbits were observed for conjunctival reaction. Follow-up fluorescein and Rose Bengal slit-lamp examinations were then performed to assess toxicity. RESULTS: Diphenhydramine solution at a 5% concentration demonstrated a significant anesthetic effect 30, 60, and 90 minutes after instillation (p < 0.0001, p = 0.0001, p = 0.0164, respectively). Mild conjunctival injection occurred in all diphenhydramine-treated eyes. No toxic effects on the corneal epithelium were observed. CONCLUSIONS: When applied topically to rabbit corneas, 5% diphenhydramine solution has a significant anesthetizing effect compared with salt solution (control eyes). Topical diphenhydramine may be a safe alternative in patients requiring topical anesthesia who have multiple allergies to topical anesthetics. Additional studies are needed to determine a dose-response curve and to further evaluate corneal toxicity prior to use in humans.

Delírium y esquizofrenia: presentación de un caso clínico / Delirium and schizophrenia: a case report

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Evaluation of the rat embryo culture system as a predictive test for human teratogens.

Ingestion of the anticonvulsant drug valproic acid and of the angiotensin converting enzyme inhibitor captopril during pregnancy has been associated with abnormal fetal outcome in humans. In contrast, the use of the antiinflammatory drug ibuprofen and the antihistamine diphenhydramine has not been documented to be embryotoxic in humans. We evaluated the rat embryo culture system as a predictive model of teratogenesis, using these four drugs as test agents. Valproic acid, ibuprofen, and diphenhydramine were embryotoxic, inducing concentration-dependent decreases in growth and a significant increase in anomalies. Valproic acid caused an increase in neural tube defects, ibuprofen increased the incidence of abnormal maxillary processes, and diphenhydramine increased the number of embryos with distorted body morphology. These abnormalities were induced at concentrations of valproic acid and diphenhydramine that are used clinically, but ibuprofen only induced toxicity at concentrations greatly exceeding the therapeutic range. Captopril was not embryotoxic up to 5 mM, the highest concentration tested. These results suggest that the rat embryo culture system produces both false positive and false negative data on the teratogenic potential of drugs. Although such an in vitro assay may be suitable to determine the mechanism of teratogenesis, it is not a sensitive indicator of potential human teratogens on its own. These data support the view that in vitro systems can only supplement clinical and epidemiological observations in humans, possibly as a method to determine mechanisms of actions of teratogens.

[Changes in the pharmacodynamic properties of promedol, droperidol and dimedrol in burn shock and combined radiation-thermal injury]. / Izmeneniia farmakodinamicheskikh svoistv promedola, droperidola i dimedrola pri ozhogovom shoke i kombinirovannom radiatsionno-termicheskom porazhenii.

Toxic and pharmacological properties of promedol, droperidol and dimedrol were studied during burn shock and combined radiation and thermal injury (CRTI). Acute toxicity and analgesic effect of promedol were shown to increase in the given period Droperidol analgesic effect enhanced in burn and CRTI, cataleptic action enhanced only in CRTI. A decrease of antihistaminic activity of dimedrol was more pronounced in CRTI.