Benadryl or Cogentin for EPS/Dystonic reactions

[Doczilla]

Our system has approved of medics using benadryl in the past to treat dystonic reactions or extrapyramidal symptoms, but we lack a specific protocol. Can anyone give me examples of systems that have a specific protocol for this?

'zilla

[FireMedic65]

Our protocol doesn't state anything very specific. Just says "if dysonic rection, may order diphenydramine."

http://www.dsf.health.state.pa.us/health/l...ve_11-01-08.pdf

page 109

Hope that helps some.

[CBEMT]

Let me know how you make out Doc. ( http://www.emtcity.com/index.php?showtopic=14938&hl= )

Edited June 2, 2009 by CBEMT

[Just Plain Ruff]

in our protocol, we have specifically 50mg of benadryl IV for Dystonic reactions. It's stated in the general medical protocol. We don't have to request orders from medical control but I call anyway because I want a 2nd opinion even if it's over the phone for the benadryl.

If the shoe fits dystonia, then put the shoe on I always say.

[HERBIE1]

in our protocol, we have specifically 50mg of benadryl IV for Dystonic reactions. It's stated in the general medical protocol. We don't have to request orders from medical control but I call anyway because I want a 2nd opinion even if it's over the phone for the benadryl.

If the shoe fits dystonia, then put the shoe on I always say.

We have no specific guidelines but have given the Benadryl many times in such cases. I simply describe the symptoms and ask for the Benadryl. Works every time.

Luckily, the worst that can happen if it does not work is a sleepy patient.

[crotchitymedic1986]

1mg/kg benadryl always worked for me

[akroeze]

Can someone make a teaching post about this? This is something I'd really enjoy learning more about but the information is so scattered when googled.

[ERDoc]

Can someone make a teaching post about this? This is something I'd really enjoy learning more about but the information is so scattered when googled.

http://emedicine.medscape.com/article/814632-overview

[chbare]

Can someone make a teaching post about this? This is something I'd really enjoy learning more about but the information is so scattered when googled.

The basic pathophysiology is though to be related to the blockade of dopaminergic receptor sites. This action is sometimes thought to create a relative state of increased cholinergic activity. It is this so called increased cholinergic activity that appears to cause the manifestations of EPS. EPS can manifest with a myriad of signs and symptoms.

The front line therapy can consist of giving an anticholinergic agent for obvious reasons. Cogentin falls into this category. Or, you can give an antihistamine with centrally acting anticholinergic properties. Non sedating antihistamines such as loratadine and cetirizine have limited central effects, and thus are not effective at treating EPS.

Take care,

chbare.