Question

Mr. C comes to the neighborhood wellness clinic where you are doing a clinical rotation. He shows you some pills and tells you his primary care provider told him to take them for an allergy, but that he does not like how they make him feel. He explains, “I always have a runny nose, and the doctor told me I’m allergic to my dog. I won’t get rid of my dog; I just love him too much. The doctor gave me these pills; I can’t afford any pills on my own. But these pills make me sleepy during the day, and I always have a dry mouth. When I told the other nurse about these problems, she told me what to do, but I forgot what she said. Can you help me? I need to take these pills.” You identify the pills as diphenhydramine. He has the following questions:

Do all drugs used to treat an allergy-induced runny nose make a person drowsy during the daytime?

What lifestyle/allergen reduction suggestions would you provide for Mr. C?

What suggestions can you offer Mr. C for coping with the side effects of diphenhydramine

Answer 1

1). Drugs used to treat an allergy-induced runny nose are anti-histamines. Diphenhydramine is a first generation anti-histamine, which causes drowsiness as a side effect.

The second generation and third generation anti-histamine drugs such as cetirizine are non-sedating. So, they can be used instead of diphenhydramine to avoid drowsiness during the daytime.

2). Mr. C has to stay away from the dog, or he has to use a mask to avoid exposure to the allergen.

3). To reduce the drowsiness of diphenhydramine during the daytime, take the drug during the evening or at bedtime. Avoid taking the drug during the daytime.