Difenhidramin: Perbedaan antara revisi
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[[File:Benadryl tablets (4438315926).jpg|thumb|left|Difenhidramin tablet]]
Difenhidramin adalah antihistamin generasi pertama yang digunakan untuk mengobati sejumlah kondisi termasuk gejala alergi dan [[gatal]]-gatal, [[pilek]], insomnia, [[mabuk gerak]], dan gejala ekstrapiramidal.<ref name="AHFS_monograph">{{cite web | url = https://www.drugs.com/monograph/diphenhydramine-hydrochloride.html | title = Diphenhydramine Hydrochloride Monograph | publisher = The American Society of Health-System Pharmacists | work = Drugs.com | url-status = live | archive-url = https://web.archive.org/web/20110615135322/http://www.drugs.com/monograph/diphenhydramine-hydrochloride.html | archive-date = 15 June 2011 | df = dmy-all }}</ref><ref name="Brown_2012">{{cite journal|vauthors=Brown HE, Stoklosa J, Freudenreich O |title=How to stabilize an acutely psychotic patient |journal=Current Psychiatary |volume=11 |issue=12 |pages=10–16 |date=December 2012 |url=http://stg.currentpsychiatry.com/pdf/1112/1112CP_Freudenreich.pdf |url-status=dead |archive-url=https://web.archive.org/web/20130514183445/http://stg.currentpsychiatry.com/pdf/1112/1112CP_Freudenreich.pdf |archive-date=14 May 2013 }}</ref> Difenhidramin juga memiliki sifat [[anestesi lokal]], dan telah digunakan pada orang yang alergi terhadap anestesi lokal umum seperti [[lidokain]].<ref name="pmid10456039">{{cite journal | vauthors = Smith DW, Peterson MR, DeBerard SC | title = Local anesthesia. Topical application, local infiltration, and field block | url = https://archive.org/details/sim_postgraduate-medicine_1999-08_106_2/page/57 | journal = Postgraduate Medicine | volume = 106 | issue = 2 | pages = 57–60, 64–6 | date = August 1999 | pmid = 10456039 | doi = 10.3810/pgm.1999.08.650 }}</ref>
===Alergi===
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===Obat Tidur===
Karena sifat sedatifnya, difenhidramin banyak digunakan dalam obat tidur tanpa resep untuk mengatasi [[insomnia]]. Obat tersebut merupakan bahan dalam beberapa produk yang dijual sebagai alat bantu tidur, baik sendiri maupun dikombinasikan dengan obat lain seperti [[parasetamol]] pada Tylenol PM dan [[ibuprofen]] pada Advil PM. Difenhidramin dapat menyebabkan ketergantungan psikologis ringan.<ref>{{cite web|url=http://allergies.emedtv.com/benadryl/benadryl-addiction.html|title=Benadryl Addiction|publisher=eMedTV| vauthors = Monson K, Schoenstadt A | date = 8 September 2013 | url-status = live | archive-url = https://web.archive.org/web/20140104053402/http://allergies.emedtv.com/benadryl/benadryl-addiction.html | archive-date = 4 January 2014 | df = dmy-all }}</ref> Difenhidramin juga telah digunakan sebagai [[anksiolitik]].<ref name="Dinndroff_1998">{{cite journal | vauthors = Dinndorf PA, McCabe MA, Friedrich S | title = Risk of abuse of diphenhydramine in children and adolescents with chronic illnesses | url = https://archive.org/details/sim_journal-of-pediatrics_1998-08_133_2/page/293 | journal = The Journal of Pediatrics | volume = 133 | issue = 2 | pages = 293–5 | date = August 1998 | pmid = 9709726 | doi = 10.1016/S0022-3476(98)70240-9}}</ref>
Difenhidramin juga telah digunakan tanpa resep oleh orang tua dalam upaya membuat anak-anak mereka tidur dan membius mereka dalam penerbangan jarak jauh.<ref>{{Cite news|url=https://www.telegraph.co.uk/travel/family-holidays/is-it-ok-drug-babies-toddlers-children-sleep-flight-antihistamines/ |archive-url=https://ghostarchive.org/archive/20220111/https://www.telegraph.co.uk/travel/family-holidays/is-it-ok-drug-babies-toddlers-children-sleep-flight-antihistamines/ |archive-date=11 January 2022 |url-access=subscription |url-status=live|title=Is it wrong to drug your children so they sleep on a flight?| vauthors = Crier F |website=The Telegraph|date=2 August 2017|access-date=13 April 2020}}{{cbignore}}</ref> Hal ini mendapat kritik, baik dari dokter maupun anggota industri penerbangan, karena pemberian obat penenang pada penumpang dapat menempatkan mereka pada risiko jika mereka tidak dapat bereaksi secara efisien terhadap keadaan darurat,<ref>{{Cite news|vauthors=Morris R|url=https://www.bbc.com/news/magazine-21977785|title=Should parents drug babies on long flights?|date=3 April 2013|work=BBC News|access-date=13 April 2020|archive-date=8 March 2021|archive-url=https://web.archive.org/web/20210308034544/https://www.bbc.com/news/magazine-21977785|url-status=live}}</ref> dan karena efek samping obat, terutama kemungkinan terjadinya paradoks. reaksi, mungkin membuat beberapa pengguna menjadi [[Gangguan pemusatan perhatian dan hiperaktivitas|hiperaktif]]. Untuk mengatasi penggunaan obat tersebut, Rumah Sakit Anak [[Seattle]] berargumentasi dalam sebuah artikel tahun 2009, "Menggunakan obat demi kenyamanan Anda tidak pernah menjadi indikasi pemberian obat pada anak."<ref>{{Cite web |vauthors=Swanson WS |date=25 November 2009 |title=If It Were My Child: No Benadryl for the Plane |url=https://seattlemamadoc.seattlechildrens.org/if-it-were-my-child-no-benadryl-for-the-plane/ |publisher=Seattle Children's |access-date=13 April 2020 |archive-date=25 February 2021 |archive-url=https://web.archive.org/web/20210225070641/https://seattlemamadoc.seattlechildrens.org/if-it-were-my-child-no-benadryl-for-the-plane/ |url-status=dead }}</ref>
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Rute utama metabolisme adalah dua demetilasi berturut-turut dari [[amina]] tersier. Amina primer yang dihasilkan selanjutnya di[[Redoks|oksidasi]] menjadi [[asam karboksilat]].<ref name="pmid2866055"/> Difenhidramin dimetabolisme oleh [[enzim]] [[sitokrom P450]] [[Sitokrom P450 2D6|CYP2D6]], CYP1A2, CYP2C9, dan CYP2C19.<ref name="pmid19153052">{{cite journal | vauthors = Krystal AD | title = A compendium of placebo-controlled trials of the risks/benefits of pharmacological treatments for insomnia: the empirical basis for U.S. clinical practice | journal = Sleep Med Rev | volume = 13 | issue = 4 | pages = 265–74 | date = August 2009 | pmid = 19153052 | doi = 10.1016/j.smrv.2008.08.001 | url = }}</ref>
Waktu paruh eliminasi difenhidramin belum sepenuhnya diketahui, namun tampaknya berkisar antara 2,4 dan 9,3 jam pada orang dewasa yang sehat.<ref name="AHFS">{{cite book|title=AHFS Drug Information|url=https://books.google.com/books?id=WR0NAQAAMAAJ|year=1990|publisher=Published by authority of the Board of Directors of the American Society of Hospital Pharmacists|access-date=9 October 2017|archive-date=14 January 2023|archive-url=https://web.archive.org/web/20230114195325/https://books.google.com/books?id=WR0NAQAAMAAJ|url-status=live}}</ref> Tinjauan farmakokinetik antihistamin tahun 1985 menemukan bahwa waktu paruh eliminasi difenhidramin berkisar antara 3,4 dan 9,3 jam dalam lima penelitian, dengan waktu paruh eliminasi rata-rata 4,3 jam.<ref name="pmid2866055"/> Sebuah studi berikutnya pada tahun 1990 menemukan bahwa waktu paruh eliminasi difenhidramin adalah 5,4 jam pada anak-anak; 9,2 jam pada orang dewasa muda; dan 13,5 jam pada orang tua.<ref name="pmid2391399">{{cite journal | vauthors = Simons KJ, Watson WT, Martin TJ, Chen XY, Simons FE | title = Diphenhydramine: pharmacokinetics and pharmacodynamics in elderly adults, young adults, and children | url = https://archive.org/details/sim_journal-of-clinical-pharmacology_1990-07_30_7/page/665 | journal = Journal of Clinical Pharmacology | volume = 30 | issue = 7 | pages = 665–71 | date = July 1990 | pmid = 2391399 | doi = 10.1002/j.1552-4604.1990.tb01871.x | s2cid = 25452263 }}</ref> Sebuah penelitian tahun 1998 menemukan waktu paruh 4,1 ± 0,3 jam pada pria muda; 7,4 ± 3,0 jam pada pria lanjut usia; 4,4 ± 0,3 jam pada wanita muda; dan 4,9 ± 0,6 jam pada wanita lanjut usia.<ref name="pmid9702844">{{cite journal | vauthors = Scavone JM, Greenblatt DJ, Harmatz JS, Engelhardt N, Shader RI | title = Pharmacokinetics and pharmacodynamics of diphenhydramine 25 mg in young and elderly volunteers | journal = J Clin Pharmacol | volume = 38 | issue = 7 | pages = 603–9 | date = July 1998 | pmid = 9702844 | doi = 10.1002/j.1552-4604.1998.tb04466.x | s2cid = 24989721 | url =
==Kimia==
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{{Refbegin}}
* {{cite journal | vauthors = Björnsdóttir I, Einarson TR, Gudmundsson LS, Einarsdóttir RA | title = Efficacy of diphenhydramine against cough in humans: a review | journal = Pharmacy World & Science | volume = 29 | issue = 6 | pages = 577–83 | date = December 2007 | pmid = 17486423 | doi = 10.1007/s11096-007-9122-2 | s2cid = 8168920 }}
* {{cite journal | vauthors = Cox D, Ahmed Z, McBride AJ | title = Diphenhydramine dependence | url = https://archive.org/details/sim_british-journal-of-addiction_2001-03_96_3/page/516 | journal = Addiction | volume = 96 | issue = 3 | pages = 516–7 | date = March 2001 | pmid = 11310441 }}
* {{cite journal | vauthors = Lieberman JA | title = History of the use of antidepressants in primary care | journal = Primary Care Companion J. Clinical Psychiatry | volume = 5 | issue = supplement 7 | pages = 6–10 | year = 2003 | url = http://www.psychiatrist.com/pcc/pccpdf/v05s07/v05s0702.pdf | access-date = 19 March 2013 | archive-date = 11 June 2014 | archive-url = https://web.archive.org/web/20140611094425/http://www.psychiatrist.com/pcc/pccpdf/v05s07/v05s0702.pdf | url-status = dead }}
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