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Introduction: Despite sparse systematic evidence, current exercise heat safety recommendations suggest that antihistamines blunt sweating and increase the risk for heat-related injury during exertional heat stress. The primary purpose of the present study was to examine whether diphenhydramine hydrochloride (DPH), a first-generation antihistamine, affects the sweating, core temperature, and heart rate (HR) response during exertional heat stress using a double-blind randomized crossover design. Methods: On two occasions separated by >48 h, 20 healthy adults (10 females, 23 ± 3 yr, body surface area: 1.9 ± 0.2 m2, body mass index: 23.7 ± 2.2 kg·m−2) orally consumed either 50 mg of DPH or placebo (PLA), and then rested for 2 h in a climate-controlled room maintained at 30°C and 35% relative humidity (heat index of ~29°C), followed by a 60-min fixed-heat production treadmill walk (6.3 ± 1.0 W·kg−1). Whole-body sweat loss, local sweat rate, rectal temperature (T rec), and HR were measured. Results: Whole-body sweat loss was not different between conditions (PLA: 406 ± 78 g, DPH: 396 ± 75 g; P = 0.26, treatment effect: −10 g; 95% confidence interval, −28 to 8). No differences were observed for the onset of sweating (PLA: 13.5 ± 2.4 min, DPH: 13.3 ± 2.7 min; P = 0.79) and steady-state local sweat rate (PLA: 0.83 ± 0.26 mg·cm−2·min−1, DPH: 0.82 ± 0.27 mg·cm−2·min−1; P = 0.99). No difference in baseline T rec was observed (PLA: 37.09°C ± 0.35°C, DPH: 37.13°C ± 0.33°C; P = 0.68), and the 60-min Δ T rec was not different (P = 0.99) between PLA (0.83°C ± 0.29°C) and DPH (0.81°C ± 0.30°C). HR was similar at baseline (PLA: 86 ± 13 bpm, DPH: 84 ± 11 bpm; P = 0.30) and end-exercise (PLA: 134 ± 28 bpm, DPH: 132 ± 26 bpm; P = 0.90). Conclusions: Fifty milligrams of DPH does not modify the sweating, core temperature, and HR response during exertional heat stress in young healthy adults. [ABSTRACT FROM AUTHOR]

Background: Diphenhydramine is an anti-tussive used periodically to treat seasonal colds, contact dermatitis, and anaphylactic reactions. This study aimed to develop a physiologically based pharmacokinetic (PBPK) model of diphenhydramine in predicting its systemic exposure among healthy pediatrics (children and adolescents) by leveraging data files from adults (young and elderly). Methods: The data profiles comprising serum/plasma concentration over time and parameters related to diphenhydramine were scrutinized via exhaustive literature analysis and consolidated in the PK-Sim software version 11.1. This modeling methodology commences with developing an adult model and then translating it to the pediatrics which compares the predicted concentration–time datasets with the reported values. Results: The accuracy of model anticipations was then assessed for each pharmacokinetics (PK) variable, i.e., the area under the curve from 0 to infinity (AUC0-∞), maximal serum/plasma concentration (Cmax), and clearance of the diphenhydramine in plasma (CL) by employing the predicted/observed ratios (Rpre/obs), and average fold error (AFE), which fell within the pre-defined benchmark of 2-fold. The predicted and observed Cmax values for pediatrics were 3-fold greater in comparison to the young adults following a 25 mg dose depicting a need to monitor dosage schedules among children closely. Conclusions: These model-based anticipations confirmed the authenticity of the developed pediatric model and enhanced the comprehension of developmental variations on PK of diphenhydramine. This may assist healthcare professionals in ensuring the significance of lifespan applicability in personalized dose regimens, promoting therapeutic efficacy and minimizing side effects in chronic conditions among children. [ABSTRACT FROM AUTHOR]

Medical emergencies, though rare, may occur unpredictably in a dental office during or after dental procedures. It may occur accidentally or subsequent to systemic problems of patients. These series of clinical events entail instantaneous management to evade any potential consequences. Basic life support measures require sufficient knowledge, expertise, skills, and equipment. Several medications and equipment are necessary to be available for immediate reach in any dental office. Health authorities of different countries usually propose these lists to dental practitioners. However, the best emergency kit is the one, which is arranged and maintained by the dentists based on their needs and easily accessible for immediate use. Considering the importance of this subject and the results yielded from the regular visits of the Dental Supervision Department (Vice Chancellor for treatment of Shiraz University of Medical Sciences) to the dental centers of Shiraz in the spring and summer of 2023, we decided to recall the importance of emergency medicines and equipment through a brief communication. [ABSTRACT FROM AUTHOR]

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