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Diphenhydramine (Benadryl) Hydrochloride in the Treatment of Ammonia Intoxication

MARVIN M. KIRSH, MD; BRUCE ABRAMS, BS; WILLIAM COON, MD; GEORGE ZUIDEMA, MD
Arch Surg. 1965;91(3):466-467. doi:10.1001/archsurg.1965.01320150096016.
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YPERAMMONEMIA is of importance in the genesis of hepatic encephalopathy. Therapy directed toward reduction of elevations of blood ammonia has been of value in the management of this condition. Neomycin, which reduces the number of urea-forming organisms in the intestine, and hypothermia, which decreases the rate of bacterial action, have been of value in lowering blood ammonia.1,2 More recently Zuidema et al have shown that monamine oxidase inhibitors are effective in the management of exogenous ammonia intoxication.3 Some antihistamines are weak monamine oxidase inhibitors.4 In addition, diphenhydramine (Benadryl) hydrochloride causes a reduction in the permeability and associated mitochondrial swelling of hepatic cells in several forms of liver damage in animals and lowers the mortality in murine hepatitis.5 This study was performed to evaluate the effect of diphenhydramine on ammonia intoxication induced in dogs.

Experiment  End-to-side portacaval shunts were constructed in eight adult mongrel dogs weighing 10

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