Risk of abuse of diphenhydramine in children and adolescents with chronic illnesses.

Diphenhydramine is generally considered an innocuous drug with a minimal risk for abuse and untoward side effects. We describe children and adolescents with chronic hematologic and oncologic diseases who exhibited drug-seeking behavior or anticholinergic symptoms with the use of diphenhydramine. These cases illustrate that the assumption that this drugs is without significant adverse effects may be unwarranted, especially for children and adolescents with chronic diseases.

Measurement of nutrient intake by deuterium dilution in premature infants.

To assess whether a simple nonrestrictive method of determining nutrient intake could be applied to premature infants, we compared actual measured formula intake during a 7-day period with intake calculated from deuterium dilution in 13 hospitalized, growing, premature newborn infants. An oral dose of deuterium oxide (D2O) was administered, and urine samples were analyzed by deuterium nuclear magnetic resonance spectrometry for D2O concentration. Using an exponential model, we calculated formula intake from the decline in D2O concentration during the 7-day study period. Intake as assessed by the deuterium model correlated well with actual intake (r = 0.93; p < 0.001). However, because the deuterium dilution model measures both dietary and nondietary water intake (metabolic and cutaneous water influx), deuterium dilution-derived intake exceeded actual intake by 25 +/- 18 ml/kg per day (16% +/- 11%). When corrections were applied to account for nondietary water intake, deuterium dilution-derived nutrient intake (160 +/- 30 ml/kg per day) closely approximated actual intake (155 +/- 17 ml/kg per day). If corrections are made for nondietary water intake, the deuterium dilution method may be a useful nonrestrictive method of measuring nutrient intake in a variety of neonatal populations.