Medicines that contain "PM" in their name are usually intended as sleep aids. Brand-name drugs such as Tylenol PM, Excedrin PM, Advil PM and Midol PM all have diphenhydramine as a common active ingredient. Diphenhydramine HCl, or citrate, is classified as an antihistamine, although because it is an anti-cholinergic agent, it displays powerful sedation properties also. Diphenhydramine, along with other common PM medicine ingredients, such as acetaminophen and ibuprofen, all produce side effects.
Diphenhydramine and Excessive Drowsiness
Drowsiness in a sleep-aid is desirable, but diphenhydramine affects the central nervous system in ways that can produce profound sedation, dizziness, confusion, increased heart rate, dilated pupils, hallucinations and altered coordination, according to Drugs.com. Due to diphenhydramine's sedating properties, it is sometimes used in the daytime as anti-anxiety medication, which can be dangerous for people operating heavy equipment and vehicles.
Diphrenhydramine and Asthma
Diphenhydramine can thicken bronchial secretions, which can precipitate bronchial asthma attacks and cause tightness in the throat and chest, coughing, wheezing and nasal congestion.
Acetaminophen and Liver Damage
The U.S. Acute Liver Failure Study Group cites that acetaminophen is implicated in about half of all acute liver failures in the United States, and that acetaminophen toxicity accounts for more than 56,000 emergency room visits and at least 450 deaths per year, as cited in a July 2004 article in "Hepatology." The maximum recommended adult daily dose of acetaminophen is 4,000 mg. Alcohol usage, liver disease, dietary fasting and concurrent pain killer usage all compound acetaminophen's risk of injuring the liver.
Acetaminophen and Kidney Damage
A clinical trial published in a 1994 edition of "The New England Journal of Medicine" concluded that about eight to 10 percent of the incidence of end-stage kidney disease in patients was attributed to "heavier" acetaminophen use. Kidney damage from acetaminophen use is rare, but acute renal failure, acute tubular necrosis and interstitial nephritis have been reported.
Ibuprofen and Kidney Damage
According to a 1997 study in the "American Journal of Therapeutics," long-term use of nonsteroidal anti-inflammatories (NSAIDs), including ibuprofen, has resulted in renal papillary necrosis, kidney toxicity and other kidney damage. Kidney disease, heart failure, liver dysfunction, diuretic usage and ACE inhibitors all compound ibuprofen's risk of damaging the kidneys.
Ibuprofen and Gastrointestinal Damage
RxList.com notes that ibuprofen use can lead to adverse gastrointestinal effects, such as gastritis, gross bleeding, stomach ulceration and perforation of the stomach or intestines. Specifically, in controlled clinical trials the percentage of patients reporting one or more gastrointestinal symptoms ranged from four percent to 16 percent.
Ibuprofen and Cardiovascular Damage
RxList notes that long-term clinical studies of several NSAIDs, including ibuprofen, have concluded that there is an increased risk of cardiovascular thrombosis, which can lead to myocardial infarctions, brain aneurysms or pulmonary embolisms. A thrombosis is plaque debris from larger arteries that get caught within smaller arteries and restrict blood flow.
References
- Drugs.com: Diphenhydramine Side Effects
- "Hepatology": Acetaminophen and the U.S. Acute Liver Failure Study Group; 2004
- "New England Journal of Medicine"; Risk of Kidney Failure Associated with the Use of Acetaminophen, Aspirin, and Nonsteroidal Antiinflammatory Drugs; Thomas Perneger et al; 1994
- "American Journal of Therapeutics": Acute Renal Papillary Necrosis Induced by Ibuprofen; 1997
- RxList.com: Ibuprofen - Motrin
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