Pharmacotherapeutic Uses of Diphenhydramine in Hospital Settings

Diphenhydramine, a first-generation antihistamine with sedative and anticholinergic effects, is a commonly used pharmacotherapeutic in hospitals. It is currently used for the treatment of hypersensitivity reactions, sedation, and even as a local anesthetic. However, several recent publications have highlighted its limitations as a first-line agent for anaphylaxis and even call for its removal. Current practice recommendations advise against using diphenhydramine as a first-line agent for anaphylaxis and acute allergic reactions. It should be reserved as an adjunct after stabilization, and even then, second-generation antihistamines like cetirizine are preferred. Due to mechanisms of action similar to amide local anesthetics, it can be safely used as an alternative in patients with known sensitivity reactions to lidocaine. Overall, diphenhydramine's hospital utility is now targeted and situation-specific. This requires careful clinical judgment and observance of safety-focused guidelines. The following report provides a review of diphenhydramine's pharmacotherapeutic uses in the hospital setting.