A TikToker Drank 2 Bottles Benadryl. This Is What Happened To Her Organs.
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- 本視頻在2020年9月16日投稿至油管
- 本文主要記述了一名TikToker為了博取關注，一次性飲用了兩大瓶苯海拉明後，她的器官的衰竭和治療過程。
正文區
本段落中所使用的歌詞，其著作權屬於原著作權人，僅以介紹為目的引用。
Hi, Doctor Bernard here.Don’t do this.
嗨！來自Bernard醫生的忠告：「千萬不要這樣做！」
Just because Benadryl is over the counter doesn’t mean it can’t do bad things.Even taking it as directed for allergies,often nets people a dullness and mental fog that lasts in to the next day.
儘管苯海拉明是非處方藥，但是這並不意味着它就百利而無一害。甚至是針對過敏反應的治療按方服用，也常常會讓人感到眩暈和精神遲鈍，並且這種感覺會持續到第二天。
DON’T DO IT!!!
千 萬 不 要 這 樣 做！！！
JC is a 21 year old woman, presenting to the emergency room, unconscious.
JC是一位21歲的女性，因昏迷送入急診室。
Her dad Scott, tells the admitting nurse that she had at least 3 seizures in the past hour.The last one went on for more than 15 minutes, before he saw his daughter fall limp likea rag doll.
她的爸爸Scott告訴入院護士，她過去一小時內至少有3次癲癇發作，最後一次持續了超過15分鐘，直到他看到他的女兒像一個布娃娃一樣軟弱無力，癱倒在地。
You see, JC was a regular college student in 2020.She just finished her finals, although, she had already moved back home earlier that spring,because of pandemic.This summertime break, was a good chance for her to pump up her internet following.With TikTok being the favorite of all her friends, she was going to become internetfamous.
如你所見，JC是在2020年的時候，還是一名普通的大學生。儘管她剛剛完成期末考試，但是由於疫情流行的影響，今年春天的早些時候她已經搬回家了。這個暑假對她來說正是一個漲粉的大好時機。適逢TikTok在她所有朋友中廣為流行，藉此機會，她將會成為知名網紅。
A small trend was growing over the weekend.This is going to be something big, she thought.
「這周末的粉絲數量有小幅上升趨勢。這將會是一件大事「。她想。
Back when she still had classes in person,she heard about Benadryl being able to “open someone’s mind.”Some of her friends tried it on the weekends.She thought she had tried it during her freshman year, but couldn’t remember. She couldn’t really remember anything from that year.
當她還在上課的時候，她聽說苯海拉明能夠「打開一個人的心靈」。她的一些朋友已經在周末嘗試過了，她以為自己在大一的時候也試過，但不記得了。她是真的不記得那年發生的事情了這大學也算是白念了。
Haha TikTok meme she thought this time around,as she danced around on camera with 2 whole bottles of Benadryl, before dumping them into her mouth.
此時，她想到了TikTok上的那些搞笑的模因。於是她便拿着兩瓶苯海拉明在鏡頭前跳舞，然後就把它們倒進了嘴裏噸噸噸了。
And immediately after finishing both bottles, JC didn’t really feel anything.She was going to be famous now.She was going to get 10 million views.“Allergy medicine go glug glug” she thought.
在剛喝完兩瓶苯海拉明後，JC就沒有什麼知覺了。她只知道自己即將出名。她將會收穫千萬播放量。她想：「兩大瓶抗過敏藥被我噸噸噸啦！」
And what she didn’t realize is that the dose of both bottles combined, can be fatal. As the hour passed, JC could feel a burning sensation at the base of her neck.Her ceiling became like jello,wobbling around.But ceilings are cringe.and floor gang now, she thought.Always have been.
但是她沒有意識到一次性飲用下兩瓶藥的量將會是致命的。一小時過去了，JC感到脖子底部有灼燒感。她看到天花板變得像果凍一樣，搖搖晃晃。啊！現在地板也開始搖晃了！她正想着，卻長時間都是如此精神遲鈍的狀態。
JC had never felt more relaxed, as she turned on some music.She could hear people chanting her name over the speakers.That’s the sound of being TikTok famous, she thought.She tried recording more videos of her trip,but eventually she forgot what she was doing.Her vision was blurry, but she didn’t need her eyes to see anymore.There was a drum beating faster and faster in her chest.Her mouth was like a desert, devoid of water, and her teeth were giant stones, grindingeach other down into sand.
當她打開音樂時，JC感到前所未有的放鬆。她能聽到人們對着喇叭喊她的名字。這就是成為TikTok網紅的聲音，她想。她想試着錄下更多關於她旅行的視頻，但是最終她還是忘記了自己正在做什麼。她的視力漸漸模糊了，但她不再需要她的眼睛去看什麼東西了。似乎正有人在她的胸腔內打鼓，越來越響。她的口乾得像缺水的沙漠，牙齒則是巨大的石頭，互相碾磨，磨成沙粒。
JC looked at the clock 12 hours had passed.Her dad had come up to her and asked, “how many Benadryl did you drink?”But she wasn’t sure if that was a hallucination or not.She said she took 10 million, which is how many TikTok views she’d get, as she suffers her first seizure.In reality, no one was around.Her dad hadn’t seen JC since hours before she took the Benadryl, as she falls unconscious on the floor.As Scott walks in on his daughter, he sees her suffer her third seizure.
JC看了看時鐘，12個小時過去了。她爸爸走到她面前問:「你喝了多少苯海拉明？」但是她不能確定這不是不她的幻覺。她說：「得有1000萬。」這是她第一次癲癇發作時，她的TikTok視頻的點擊量。事實上，她的周圍並沒有人。在她喝下用苯海拉明之前，她的父親已經有幾個小時沒見過JC了，當時她正倒在地板上失去了知覺。當Scott走進他的女兒時，他看到她的第三次癲癇發作。
While he called 911, and while the ambulance was on its way, JC’s seizure wouldn’t stop.But when paramedics arrived, she fell limp.Her dad had no idea what happened as she arrives to the emergency room, where we are now.
他撥打了911，救護車也趕來的路上，但是JC的癲癇一直沒有停止。當醫護人員趕到時，她無力地癱倒了下來。當她被送到到達急救室時，也就是我們現在所在的地方，她爸爸並不知道她到底發生了什麼。
At examination, JC was unresponsive.She was flushed, but she didn’t have a fever.Her heart rate was 180 beats per minute, about3 times more than normal, but her blood pressure was 70 over 40, about half of normal.No one there had any idea that JC had taken a whole bottle of Benadryl, but there’s a few clues as to what could be happening.
在檢查時，JC仍然沒有意識。她的臉發紅，但是她並沒有發燒。她的心率是每分鐘180次，大約是正常人的3倍，但是她的血壓是每分鐘70~40，大約是正常人的一半。沒有人知道JC服用了一整瓶的苯海拉明，但是對於可能發生的事情還是有一些線索。
JC’s skin was red, but she wasn’t sweating.Her pupils were dilated, and were minimally reactive to light.Her mouth was dry, just like all her mucous membranes.Her heart was beating fast.All of this together, signals anticholinergic poisoning.
JC的皮膚是泛紅，但她沒有出汗。她的瞳孔擴大了，但是瞳孔對光反射消失。她的嘴很乾，就像她所有的粘膜一樣。她的心跳得很快。所有這些線索都指向了抗膽鹼能藥物中毒。
-But what does that mean? -What is a cholinergic? -And what does it have to do with Benadryl?
-但是，這又是什麼意思呢？ -什麼是膽鹼能？ -它和苯海拉明有什麼關係？
Well, Benadryl is an allergy medicine.Its chemical name is diphenhydramine.Lots of people take it in the spring, when flowers are blooming.Pollen and allergens cause people to sneeze.To cough.To have a runny and stuffed nose.The body thinks these allergens are foreign objects that need to be removed.What’s a good way to remove things?Well you could dilate the blood vessels, and make them more leaky, in the hopes that the allergens will leak out.
苯那君是一種抗過敏藥，它的化學名稱是苯海拉明。很多人會在春天花開的季節服用。因為花粉會成為過敏原，導致人們打噴嚏、咳嗽、流鼻涕和鼻塞。人體認為這些過敏原是需要被人體清除的異物。那麼如何移除它們呢？那麼，擴張血管，使它們更容易滲漏，這樣過敏原就會滲出來。
Benadryl stops this allergic reaction by stopping the signal for it, which is from a natural chemical that’s made in your body, called Histamine.Hist- from histidine, which is an amino acid, a building block of proteins in your body,and Amine referring to nitrogen which is a base word for amino acid.
苯海拉明則通過阻斷過敏信號來阻止過敏反應，這種信號來自一種你體內產生的叫做「組胺」的天然化學物質。「Hist-」意思是來自組氨酸，組氨酸是一種氨基酸，是你體內蛋白質的組成部分之一，「Amine」指的是氮，氮是組成氨基酸的基礎原料。
-But if Benadryl is just an over the counter allergy medicine, why did it cause JC to hallucinate?
It’s not like you’re stopping allergies in the brain!
-但如果苯那君只是一種非處方的抗過敏藥，那麼為什麼它能導致JC產生幻覺呢?
這並不意味着你正在阻止大腦發生過敏反應！
-And why is her heart beating so fast?
As the doctors keep examining her, they find she has a pulse, but her heart is beating in a way, that if nothing is done about it, her heart will just shake in place, and won’t be able to produce an actual contraction.
-那為什麼她的心跳這麼快?
通過醫生對她的檢查，他們發現她有還脈搏，但是她的心臟在某種低水平的程度上顫動着，如果不採取任何措施，她的心臟只會原地顫動，並不會產生真正的收縮。
Doctors shock her in to a normal heart rhythm.And after this happens, JC’s dad realizes his daughter had posted some TikTok videos of her drinking 2 whole bottles of diphenhydramine.He shows this to the doctors, and it tells them everything that they need to know.
醫生通過電擊終於使她恢復正常心律。在這之後，JC的父親突然意識到，關於他的女兒喝了整整兩瓶苯海拉明這件事，她曾經上傳的一些TikTok視頻。他把這些視頻給醫生看，並且終於了解了他們需要了解的一切事情的起因。
Diphenhydramine inactivates histamine receptors.It doesn’t stop the immune system from releasing histamine, it stops your body from interacting with it.When you take the dose on the instructions for allergies, this inactivates enough of the histamine receptors, so that you don’t have a reaction.But if someone takes too much, like lets say a 2 WHOLE BOTTLES, then that person is going to have a lot of diphenhydramine floating around in the body, meaning it’s going to interact with more than just histamine receptors.
苯海拉明的作用是使組胺受體失活。它並不會阻止免疫系統釋放組胺，從而阻止你的身體與組胺互動。當你按照指示服用劑量時用於抗過敏時，苯海拉明就會使組胺受體失去活性，這樣你就不會產生過敏反應。但如果一個人服用過量，比如整整兩瓶，那麼這個人體內就會漂浮着過量的游離的苯海拉明，這意味着苯海拉明不僅僅只與組胺受體相互作用。
-But, what else would that be?
Well, if you’ve ever taken diphenhydramine,you know it can make you sleepy.That’s why it’s branded as a sleep aid too.Some parents give it to their kids before a flight so that the kid will sleep on the plane and not cause a ruckus.You shouldn’t do that to your kids.
-那麼，這些苯海拉明會到哪裏去呢?
如果你曾服用過苯海拉明，你就會知道它能讓你昏昏欲睡。這就是為什麼它也被常常用於助眠。有些家長會在飛機起飛前給孩子服用，這樣熊孩子們就只能在飛機上乖乖睡覺，而不是大吵大鬧。但是，你不應該這樣對你的孩子！！！
But if you’ve ever taken it for sleep, you know you don’t wake up feeling great.All of this means that Benadryl acts on the brain.Which is clearly what it did to JC because as doctors transfer her into the intensive care unit, she suffers her fourth seizure.
但是如果你曾經為了入眠而服用過它，你就會知道，當你醒來時，你其實並不會感到很舒服。這一切事情都意味着，苯海拉明會對大腦起作用。JC顯然就是這樣，因為當醫生把她轉到重症監護室時，她的第四次癲癇發作了。
Nurses had to give medicine to stop the seizure, because it wouldn’t stop on its own.The Benadryl deposits not just in her brain, but in all her organs because she took so much of it.This brings us to an idea called Lipophilicty.Lipo- meaning fat and Philic meaning affinity for.
護士們不得不給藥來阻止JC的癲癇發作，因為它無法自己停止。因為她攝取了太多苯海拉明，所以不僅在她的大腦中，還在在她的所有器官中，都聚集着大量的苯海拉明。這給我們帶來了一個叫做「親脂性」的概念。「Lipo-」的意思是脂肪，「Philic」的意思是親和力。
Benadryl is lipophilic, meaning it dissolves in fat.We know that water doesn’t mix well with oil, which is a fat.Outside of the cells in the human body, there’s a bilipid layer, meaning your cells are coated and defined by a layer of fat.This would mean that a lot of Benadryl doesn’t want to be in the blood, because blood is mostly made of water— it would want to be in the cells, so it can interact with that bilipid layer.And, more than 60% of the brain is made of fat, which is how Benadryl would get in.
苯海拉明是親脂性的，也就是說，它可以溶解在脂肪中。我們都知道，水和油並不互溶，因為油是一種脂肪。在人體細胞的外層是一層脂質層，這意味着你的細胞被一層脂肪包裹着。這意味着大量的苯海拉明不容易存在於血液中，因為血液主要是由水構成的——它更容易存在於細胞中，這樣它就可以與膽脂層相互作用。而且，大腦是的組成成分中，超過60%是脂肪，這就是為什麼苯海拉明會在大腦中大量聚集。
Do you remember those histamine receptors? Well they’re not just in the lungs and the skin to cause an allergic reaction.They’re also in the brain.And while histamine can cause blood vessels to dilate and become leaky elsewhere in the body, in the brain it does different things.It regulates sleep and wakefulness, so if Benadryl is there, cells don’t respond to histamine anymore, so there’s no more regulation, and no more wakefulness.That’s how it causes drowsiness. Histamine’s also involved in cognition.So if Benadryl is there to block it, then there’s less cognition.Less cognition could mean more hallucinations, which sounds a lot like JC’s case.Histamine also has anticonvulsant activity, so if Benadryl is there to inactivate it, then there would be convulsant activity, explaining her seizures.
你還記得那些組胺受體嗎?它們不只是在肺和皮膚中引起過敏反應。它們同樣也存在於大腦中。雖然組胺能導致身體其他部位的血管擴張和滲漏，但它在大腦中卻有着不同的作用。它會調節你的睡意和清醒狀態。如果大腦中聚集有苯海拉明，腦細胞就不會再對組胺做出反應，所以就不能調節睡眠狀態狀態，也難以再清醒。這就是它引起睡意的原因。組胺也與認知有關。如果苯海拉明阻止了組胺的作用，那麼認知就會減弱。更弱的認知就意味着更強的幻覺，正如JC的案例一樣。組胺同樣也有抗驚厥活性，如果有苯海拉明來滅活組胺，那麼抗驚厥活性就失效了，這就解釋了她癲癇發作的原因。
But she doesn’t just have a little bit of Benadryl in her body, she has 2 whole bottles of it.But if it’s sitting in her organs, blocking all the histamine receptors, and there’s still a lot of it floating around, what else would it block?
但她體內並不是只有一點點苯海拉明，而是整整兩瓶。但如果苯海拉明在她的器官中，已經阻斷了所有的組胺受體，而且還有大量的組胺在各處游離，那麼，它還會破壞什麼?
This brings us back to “anticholinergic poisoning”.
這讓我們回到「抗膽鹼能中毒」這個概念上來。
A “cholinergic” refers to the naturally occurring chemical called choline.Which happens to have a similar structure to Benadryl.One part of your nervous system signals for “rest and digest”.This is mediated by the chemical acetylcholine, which is made inside your body.And cholinergic receptors, take in acetylcholine to promote “rest and digest.”But interestingly enough, since we have sequenced the entire human genome, we know what the DNA in our body makes.Nature likes to conserve things, and our genome tells us that almost half of this cholinergic receptor, is just like the histamine receptor.And because Benadryl isn’t too different in structure from choline, then it means having a massive amount of Benadryl in the body, would cause it to bind to cholinergic receptors too.A lot of Benadryl means a lot of these cholinergic receptors don’t get acetylcholine anymore, they get Benadryl instead, meaning, JC’s body can’t signal “rest and digest” either.
「膽鹼能」指的是一種被稱為膽鹼的天然化學物質。它和苯海拉明的結構很相似。你的部分神經系統會發出「休息和消化」的信號。這是由你體內產生的化學物質乙酰膽鹼所介導的。膽鹼能受體，通過與乙酰膽鹼結合，從而身體促進「休息和消化」。「但有趣的是，既然我們已經完成了整個人類基因組的排序，那我們就知道我們體內的DNA會產生什麼。」大自然總是喜歡有所保留，我們的基因組告訴我們，幾乎一半的膽鹼能受體，就像組胺受體一樣（容易被苯海拉明滅活）。因為苯海拉明在化學結構上與膽鹼沒有太大區別，這也意味着體內有過量的苯海拉明會與膽鹼能受體結合。大量的苯海拉明滅活了膽鹼能受體，意味着很多膽鹼能受體無法得到正確的信號分子——乙酰膽鹼，而是得到苯海拉明，也意味着JC的身體也不能發出"休息和消化"的信號。
Without a digest signal, her mouth becomes dry so no more saliva.Her stomach muscles don’t move anymore.She becomes flushed, but can’t sweat.She can’t and hasn’t urinated since she took the whole bottle of Benadryl.Her pupils become dilated.And her heart doesn’t slow down, it speeds up to the point where it shakes in place and doesn’t actually produce a real contraction.
因為沒有消化信號，所以就不再分泌唾液，她的嘴就會變干。她的腹部肌群也不再運動了。她的臉頰泛紅，但沒有出汗。而且自從她喝下了整瓶的苯海拉明後，她不能，也無法正常排尿。她的瞳孔放大。但她的心臟並沒有減速，而只是加速顫抖，並沒有產生真正的收縮。
In the intensive care unit, doctors give medicines to try and stabilize her heart rhythm.Benadryl doesnt just stop the histamine signal, it doesn’t JUST stop the rest and digest signal.It also blocks sodium going in to heart muscle cells because the other part of its shape happens to fit in those receptors in the heart too.And because JC took a huge amount of it, there’s enough extra floating around to block anything where it can fit.
在重症監護室，醫生通過給藥來試圖穩定她的心律。因為苯海拉明不只是阻斷組胺信號，也不只是阻斷休息和消化信號。它還阻斷鈉進入心肌細胞，因為它的另一部分碰巧也適合心臟中的受體形狀相吻合。正因為JC攝入了過量的苯海拉明，所以也有足夠多的額外游離的苯海拉明來阻斷任何的東西，從而使她心律失常。
Is there any way we could happen to pull it out of her organs?
Well, maybe. But in most cases, this is treated by... waiting it out.
有沒有辦法能把這些苯海拉明從她的器官里排出來呢?
嗯,也許吧。但在大多數情況下，便是……等待它自己排出來。
Give medicines to stabilize her heart. Give medicines to stop her seizures if they happen. Ventilate her so that a machine breathes for her because she can’t do it on her own. But maybe, there is a way we can exploit the chemical property of Benadryl to treat her.
給她注射用來穩定心率的藥物。如果癲癇發作，則給她注射抗癲癇藥物。因為她不能自主呼吸，所以給她通氣管，並讓呼吸機機器替她的自主呼吸。但也許，我們可以利用苯海拉明的化學性質來治療她。
Bringing us back to lipophilicity.If Benadryl dissolves in fat, but not water, could we somehow infuse fat into her veins in the hopes that it would pull out Benadryl from her organs? At this thought, doctors infused the lipid emulsion used to feed critically ill patients, intravenously.JC’s heart rhythm didn’t change after the first infusion. It’s still unstable.Twenty minutes later, doctors infuse another bolus in, and then, her heart stabilizes, and throughout the duration of her stay in the hospital, she never has another abnormal heart rhythm.
回到親油性上來。如果苯海拉明更容易溶解在脂肪里，而不是水裏，我們能不能用某種方法把脂肪注入她的靜脈，來嘗試把苯海拉明從她的器官里排出來？有了這個想法後，醫生們將用於餵養危重病人的脂質乳劑靜脈注射進去。JC的心率在第一次注射後沒有變化。它仍然是不穩定的。20分鐘後，醫生又給她注射了一劑，終於，她的心臟穩定了下來，在她住院期間，她的心律再也沒有出現過異常。
In several case reports of this intravenous lipid emulsion therapy for various toxicities,a positive inotropy was observed, meaning after infusion of fat emulsion, the heart beats harder and stronger.It’s possible that it could be the heart muscle changing energy source from glucose to fatty acid from the emulsion.
在一些病例報告中，血脂乳狀液治療多種毒副反應均呈正性肌力，即脂肪乳狀液注射後心臟跳動更強。有可能是心肌細胞將能量來源從葡萄糖轉變為乳劑中的脂肪酸。
But it could also be additional volume in the blood stretching the heart and causing a rebound reflex.Or it could just be because the toxicity has been reversed.That’s the good part. Sometimes, that bolus of fat can cause pancreatitis, cause the pancreas is supposed to help break down fats, and it can also cause acute respiratory distress, that would be the bad part.
但這種方法會增加血液中額外的容量，擴展心臟，引起心血管的減壓反射。往好的方向來說，它可能會讓毒性已經逆轉。往糟糕的方向來說，有時候，那一團脂肪會引發胰腺炎，因為胰腺應該幫助身體分解這些大量的脂肪，同時它也會引起急性呼吸窘迫。
But in this case, JC turned out OK.And on day 3 of hospitalization, she pulled out the tube that was down her throat.Confused as to where she was, her dad explained to her everything that happened, as she realized that the TikTok fame wasn’t worth the memes, especially since she felt a mental fog and haze from the event, for several months afterwards.
儘管如此，JC的最終結果是好的。在住院治療的第三天，她拔掉了喉管。父親向不知道自己身在何處的她解釋了發生的一切，她意識到TikTok的名氣並不不值得，尤其是在這件事之後的幾個月，她一直感到精神恍惚。
Viral following is almost never worth it.Because fast up is fast down.Brightest stars burn out the fastest.
博取病毒式的跟風關注從來都是不值得嘗試的。恰似海上的浪潮一樣，騰湧而起後必定會狠狠地摔落。要知道，最閃耀的恆星也衰竭得最迅速。
Thanks so much for watching, take care of yourself, and be well.
非常感謝您的觀看，照顧好自己，並祝你身體健康。
筆記
Benadryl,系統命名法:2-(diphenylmethoxy)-N,N-dimethylethanamine
國內通常翻譯為苯那君、苯海拉明。
苯海拉明是一種抗組胺藥，是第一代的H1拮抗劑，會阻斷一些組織胺的作用，所以可以用來治療過敏性皮膚黏膜疾病。
也可以用於治療失眠、感冒症狀、帕金森氏症震顫和噁心（但是作用機制不清楚）。
苯海拉明常見的副作用包括嗜睡、方向感不佳以及反胃，不建議給嬰兒服用。目前還不清楚在懷孕時使用的風險，不過不建議在哺乳時服用此藥物。