DIPHENHYDRAMINE AND RELATED AGENTS

DiphenhydrAMINE is used to treat symptoms of upper respiratory allergies or common cold. It is also used to treat insomnia, motion sickness, parkinsonism symptoms, and allergic reactions to blood or blood plasma (Prod Info diphenhydramine hcl injection, 2006a; Prod Info BENADRYL(R) ALLERGY oral capsules, 2006; Prod Info CHILDREN'S BENADRYL(R) ALLERGY dissolving oral tablets, 2006; Prod Info UNISOM(R) SLEEPGELS(R) oral gelcaps, 2006). Topical diphenhydrAMINE is used as an anti-itch product (Prod Info Benadryl(R) Itch Stopping Cream Extra Strength, 2004; Prod Info Benadryl(R) Itch Stopping Gel Original Strength, 2004; Prod Info Benadryl(R) Itch Stopping Spray Original Strength, 2004; McNeil Consumer Healthcare, 2010).

DIMENHYDRINATE

DimenhyDRINATE is used to prevent and treat symptoms (nausea, vomiting, dizziness) associated with motion sickness (Prod Info DRAMAMINE(R) chewable oral tablets, 2006; Prod Info dimenhydrinate IM, IV injection, 2008).

FORMS

DIPHENHYDRAMINE is available in the following dosage forms:

25 mg or 50 mg capsules, tablets, gelcaps or liquicaps (Prod Info UNISOM(R) SLEEPGELS(R) oral gelcaps, 2006; Prod Info BENADRYL(R) ALLERGY oral capsules, 2006).
12.5 mg chewable tablets (Prod Info BENADRYL(R) chewable tablets, 2006).
25 mg orally dissolving strip (approximately 10 strips per box) (McNeil Consumer Healthcare, 2010).
12.5 mg/5 mL elixir or syrup (Prod Info CHILDREN'S BENADRYL(R) ALLEGY oral liquid, 2006).
10 mg or 50 mg/mL injection (Prod Info diphenhydramine hcl injection, 2006).
1% or 2% cream in a 30 gram tube (Prod Info BENADRYL(R) extra strength cream, 2006).
2% topical spray in 7.7 mL or 60 mL container (Prod Info Benadryl(R) Itch Stopping Spray Original Strength, 2004; McNeil Consumer Healthcare, 2010).
DiphenhydrAMINE is also available in combination products containing acetaminophen, ibuprofen, phenylephrine, dextromethorphan or hydrocodone (Prod Info ADVIL(R) PM oral liquid filled capsules, 2005; Prod Info Tylenol(R) PM,, 2004; Prod Info DYTAN-DM(TM) oral suspension, 2006; Prod Info D-TANN chewable oral tablets, 2006; Prod Info HYDRO-DP oral syrup, 2005).

DIMENHYDRINATE is available as 50 mg tablets, 50 mg chewable tablets, 12.5 mg/5 mL, and 50 mg/mL injection (Prod Info DRAMAMINE(R) chewable oral tablets, 2006; Prod Info dimenhydrinate IM, IV injection, 2008).

-CLINICAL EFFECTS

GENERAL CLINICAL EFFECTS

USES: DiphenhydrAMINE and dimenhyDRINATE are sedating antihistamines used to treat allergic conditions, motion sickness and are used as a sleep aid. Occasionally used as a drug of abuse.

PHARMACOLOGY: Competitive antagonist of histamine at the H1 receptor.

TOXICOLOGY: Anticholinergic (primarily antimuscarinic) effects develop in overdose. DimenhyDRINATE toxicity is similar in nature to diphenhydrAMINE toxicity.

EPIDEMIOLOGY: Poisoning is common but rarely severe. May occur via oral, parenteral or dermal route.

WITH POISONING/EXPOSURE

MILD TO MODERATE POISONING: Somnolence, anticholinergic effects (mydriasis, flushing, fever, dry mouth, urinary retention, decreased bowel sounds), tachycardia, mild hypertension, nausea and vomiting are common after overdose. Agitation, confusion and hallucinations may develop with moderate poisoning.
SEVERE POISONING: Effects may include delirium, psychosis, seizures, coma, hypotension, QRS widening, and ventricular dysrhythmias, including torsades de pointe, but are generally only reported in adults after ingestions of one gram or more of diphenhydrAMINE. Rhabdomyolysis and renal failure may rarely develop in patients with prolonged agitation, coma or seizures.

WITH THERAPEUTIC USE

ADVERSE EFFECTS: Mild sedation, dizziness, impaired coordination, and mild anticholinergic effects are common, paradoxical excitation develops in some patients.

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-FIRST AID

FIRST AID AND PREHOSPITAL TREATMENT

Prehospital gastrointestinal decontamination is not recommended because of potential for somnolence and seizures.

-RANGE OF TOXICITY

MINIMUM LETHAL EXPOSURE

CASE REPORTS

ADULT

Fatality was reported in an adult after ingestion of 25 mg/kg (Treibergs & Lovejoy, 1983).
A fatality was reported in an adult after ingestion of 5,000 mg dimenhyDRINATE (Winn & McDonnell, 1993).
Acute ingestion of 7.5 grams of diphenhydrAMINE in a 14-year-old girl resulted in grand mal seizures, hypotension, severe acidosis, and death (Krenzelok et al, 1982).
A 48-year-old woman ingested an unknown amount of guaifenesin, diphenhydrAMINE, and chlorpheniramine in overdose and was found dead. The diphenhydrAMINE blood concentration was 8.8 mg/L, approximately 100 times greater than the average peak plasma concentration following a single therapeutic dose. Elevated levels of guaifenesin (approximately 20 times the therapeutic dose) and chlorpheniramine (approximately 10 times the therapeutic dose) were also found and it is unclear whether a particular agent or a combination of these agents caused her death (Wogoman et al, 1999).

INFANT

An 18-month-old, 10-kg-infant developed grand mal seizures following rectal administration of 3 doses of 50 mg of pyrilamine maleate over 24 hours (Reyes-Jacanq & Wenzl, 1969).

DiphenhydrAMINE 30 mg was administered parenterally for initial control of seizures. Status epilepticus developed shortly thereafter. The child died 10 hours after hospitalization.

Ingestion of an estimated 495 mg (33 mg/kg) resulted in status epilepticus and death 7 days postingestion in a 15-month-old child (Goetz et al, 1990).
A 9-week-old 5.4 kg infant died after ingesting 62.5 mg diphenhydrAMINE(Baker et al, 2003).

MAXIMUM TOLERATED EXPOSURE

ADULT

Patients 6 years of age and older with acute ingestions of less than 7.5 mg/kg or 300 mg (whichever is less) re unlikely to develop significant toxicity (Scharman et al, 2006).
CASE REPORTS

A 35-year-old woman developed hypotension, lethargy, generalized seizures, and prolonged QRS and QTc intervals following a deliberate ingestion of 16 grams of diphenhydrAMINE in a suicide attempt (Mullins et al, 1999).

In a similar case, a healthy 26-year-old man ingested 25 g of diphenhydrAMINE and developed lethargy, coma, generalized seizures, and prolonged QRS and QTc interval. Torsades de pointes occurred approximately 6.5 hours after ingestion, and laboratory evidence of metabolic acidosis and hypokalemia were also observed (Joshi et al, 2004) .

A 39-year-old man ingested 2.4 grams of diphenhydrAMINE in a suicide attempt and subsequently developed hyperthermia, akinesia, rhabdomyolysis, and a decrease in consciousness (Park-Matsumoto & Tazawa, 1999).
A 22-year-old woman ingested 5 grams of diphenhydrAMINE, experienced severe toxicity, and survived with residual encephalopathy (Rinder et al, 1988).
DiphenhydrAMINE dependence with no apparent physical effects were reported in a 34-year-old man taking 1,600 mg daily (Feldman & Behar, 1986).
Severe toxicity (seizure, wide-complex tachycardia) was described in a 17-year-old after ingestion of 750 mg of diphenhydrAMINE (Clark & Vance, 1992).
A 17-year-old ingested 2,000 mg of diphenhydrAMINE in a suicide attempt, subsequently became unresponsive, and developed tachycardia, tachypnea, bundle branch block with QT interval prolongation, seizures, hypotension, and metabolic acidosis. The patient recovered with supportive care (Thakur et al, 2005).
A 23-year-old man presented to the emergency department hypotensive (73/32 mmHg) and tachycardic (145 beats/min) after ingesting 2000 to 2500 mg of diphenhydrAMINE. Prior to presentation, emergency responders witnessed a generalized tonic clonic seizure and obtundation of the patient, necessitating ventilation. His initial ECG revealed sinus tachycardia with intraventricular conduction delay, with a QRS width of 172 msec, and a prolonged QTc interval of 577 msec. A venous blood gas analysis indicated metabolic acidosis, and laboratory data revealed a serum diphenhydrAMINE level of 4100 ng/mL (therapeutic range 50 to 100 ng/mL). Treatment included 2 cardioversions for wide complex tachycardia, IV sodium bicarbonate, magnesium sulfate, calcium gluconate, and 2 IV boluses of 20% lipid emulsion, each at a dose of 1.5 mL/kg, administered 20 minutes apart. Within 5 minutes after the second lipid emulsion bolus dose, the patient's QRS width narrowed to 106 msec and his wide complex tachycardia resolved, returning to sinus rhythm with a heart rate of 115 beats/minute. He was extubated on hospital day 3 and, other than development of an elevated lipase level, he recovered uneventfully (Abdi et al, 2014).

CASE SERIES

ADULT: In a large series of adult overdoses with diphenhydrAMINE alone (232 studied retrospectively and 50 studied prospectively) serious intoxication (delirium, psychosis, seizures, coma) only developed after ingestion of one gram or more (Radovanovic et al, 2000)

PEDIATRIC

Children less than 6 years of age with acute ingestion of less than 7.5 mg/kg are unlikely to develop significant toxicity (Scharman et al, 2006).
GENERAL: Children, in particular infants tend to be more sensitive to the toxic effects of diphenhydrAMINE than adults.
In a review by Baker et al (2003) small doses of diphenhydrAMINE can produce severe toxicity in children. In one case a 34-month-old (11.5 kg) ingested only 50 mg of diphenhydrAMINE and developed ataxia, aphasia, and grand mal seizures; and a 13-month old (10 kg) ingested between 100 to 150 mg diphenhydrAMINE and developed respiratory arrest with left bundle branch block and seizures. Both recovered with supportive care. The authors concluded that children and, in particular, infants appear to develop more severe CNS stimulation (including seizures), as compared to adults with supratherapeutic blood diphenhydrAMINE levels; this appears to improve with age (Baker et al, 2003).
Acute ingestions in the range of 10 to 15 mg/kg have caused severe toxicity (seizures, respiratory arrest, dysrhythmias) in young children (Scharman et al, 2006).
CASE SERIES: In a prospective study of 184 cases of diphenhydrAMINE (n=131) or dimenhyDRINATE (n=53) ingestions in children 18 years of age or less, the mean age was 5.2 years, with a mean weight of 20.6 kg. A total of 50 cases (not specified as diphenhydrAMINE or dimenhyDRINATE) were symptomatic on presentation; CNS depression (56%), tachycardia (18%), and hypertension (18%) were observed. Of these cases, the mean age was 8.9 years with a mean ingested dose of 17.3 mg/kg (Zavitz et al, 1989).
CASE REPORT: Ingestion of 700 to 800 mg of diphenhydrAMINE (50 to 60 mg/kg) was not fatal to a three-year-old child (Dverfeldt, 1947).

INFANT

SEIZURE: As little as 150 to 200 mg of diphenhydrAMINE in an 18-month-old child (Wyngaarden & Seevers, 1951) has resulted in seizures.
A 13-month-old infant developed wide complex tachycardia, prolonged QTc interval, tachypnea, nystagmus, agitation alternating with lethargy, a single tonic clonic seizure, and dry, flushed skin after an unintentional suspected maximal ingestion of 24 25-mg diphenhydrAMINE tablets (50 mg/kg). With supportive care, the patient recovered within 24 hours and was discharged without sequelae (Cole et al, 2011).

ROUTE OF EXPOSURE

DERMAL EXPOSURE

In a 7-year retrospective study, 6 patients (mean age 5 years) were identified with diphenhydrAMINE toxicity following total body application of 2 to 6 ounces of Caladryl(R) lotion over 24 to 48 hours (Goetz & Krenzelok, 1989).
A 2.5-year-old boy presented with visual hallucinations following topical application of a warmed solution of calamine-diphenhydrAMINE hydrochloride to his entire body (Reilly & Weisse, 1990).
A 5-year-old boy developed bizarre behavior with visual hallucinations associated with administration of 3.6 mg/kg of oral diphenhydrAMINE over 36 hours and topical application of 3 ounces of calamine-diphenhydrAMINE lotion over 12 hours (Woodward & Baldassano, 1988).
A 9-year-old boy presented with agitation, confusion, hallucinations, and a serum diphenhydrAMINE concentration of 1.4 mg/liter after dermal application to treat skin eruptions (Filloux, 1986).
Psychotic symptoms usually appear with doses greater than 600 mg/day of dimenhyDRINATE (Craig & Mellor, 1990).

CHRONIC

CASE REPORT: A 35-year-old schizophrenic man ingested 8 to 10 25-mg diphenhydrAMINE capsules daily over an 11-year period. Randomly measured plasma drug concentrations reflected an even higher intake. There were no signs of anticholinergic delirium. There was no attempt at withdrawal (Isabelle & Warner, 1999).

Carcinogenicity Ratings for CAS58-73-1 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed
EPA (U.S. Environmental Protection Agency, 2011): Not Listed
IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

TOXICITY AND RISK ASSESSMENT VALUES

EPA IRIS

EPA Risk Assessment Values for CAS58-73-1 (U.S. Environmental Protection Agency, 2011):

Not Listed

TOXICITY VALUES

References: RTECS, 2000
- LD50- (INTRAPERITONEAL)MOUSE:
- LD50- (INTRAVENOUS)MOUSE:
- LD50- (ORAL)MOUSE:
- LD50- (SUBCUTANEOUS)MOUSE:
- LD50- (INTRAPERITONEAL)RAT:
- LD50- (INTRAVENOUS)RAT:
- LD50- (ORAL)RAT:
- LD50- (SUBCUTANEOUS)RAT:

-STANDARDS AND LABELS

WORKPLACE STANDARDS

ACGIH TLV Values for CAS58-73-1 (American Conference of Governmental Industrial Hygienists, 2010):

Not Listed

AIHA WEEL Values for CAS58-73-1 (AIHA, 2006):

Not Listed

NIOSH REL and IDLH Values for CAS58-73-1 (National Institute for Occupational Safety and Health, 2007):

Not Listed

OSHA PEL Values for CAS58-73-1 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS58-73-1 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

ENVIRONMENTAL STANDARDS

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS58-73-1 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS58-73-1 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA RCRA Hazardous Waste Number for CAS58-73-1 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA SARA Title III, Extremely Hazardous Substance List for CAS58-73-1 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS58-73-1 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Not Listed

DOT List of Marine Pollutants for CAS58-73-1 (49 CFR 172.101 - App. B, 2005):

Not Listed

EPA TSCA Inventory for CAS58-73-1 (EPA, 2005):

Listed as: Ethanamine, 2-(diphenylmethoxy)-N,N-dimethyl-

LABELS

NFPA

NFPA Hazard Ratings for CAS58-73-1 (NFPA, 2002):

Not Listed

-PERSONAL PROTECTION

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

PROTECTIVE CLOTHING

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 58-73-1.

Specific recommendations and test data for this chemical were not found in the available manufacturers' product literature. A complete list of consulted manufacturers and references is presented below.

-PHYSICAL HAZARDS

FIRE HAZARD

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

FLAMMABILITY CLASSIFICATION

NFPA Flammability Rating for CAS58-73-1 (NFPA, 2002):

Not Listed

FIRE CONTROL/EXTINGUISHING AGENTS

Editor's Note: An ERG guide with information appropriate to this material does not exist.

NFPA Extinguishing Methods for CAS58-73-1 (NFPA, 2002):

Not Listed

EVACUATION PROCEDURES

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

AIHA ERPG Values for CAS58-73-1 (AIHA, 2006):

Not Listed

DOE TEEL Values for CAS58-73-1 (U.S. Department of Energy, Office of Emergency Management, 2010):

Not Listed

AEGL Values for CAS58-73-1 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

NIOSH IDLH Values for CAS58-73-1 (National Institute for Occupational Safety and Health, 2007):

Not Listed

CONTAINMENT/WASTE TREATMENT OPTIONS

SUMMARY

Editor's Note: An ERG guide with information appropriate to this material does not exist.

SMALL LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

LARGE LEAK/SPILL

Editor's Note: An ERG guide with information appropriate to this material does not exist.

-PHYSICAL/CHEMICAL PROPERTIES

MOLECULAR WEIGHT

DIMENHYDRINATE: 469.96 (Prod Info dimenhydrinate IM, IV injection, 2008)

DIPHENHYDRAMINE HYDROCHLORIDE: 291.82 (Prod Info Diphenhydramine Hydrochloride oral solution, 2008; Prod Info diphenhydramine hcl injection, 2006)

DESCRIPTION/PHYSICAL STATE

DIPHENHYDRAMINE HYDROCHLORIDE: White, crystalline powder that is freely soluble in water and alcohol (Prod Info Diphenhydramine Hydrochloride oral solution, 2008; Prod Info diphenhydramine hcl injection, 2006)

DIPHENHYDRAMINE HYDROCHLORIDE: 4 to 6.5 (Prod Info diphenhydramine hcl injection, 2006)

-REFERENCES

GENERAL BIBLIOGRAPHY

40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.

40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.

49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.

62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.

65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.

67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.

68 FR 42710: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2003.

69 FR 54144: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2004.

AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.

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Information to evaluate chemical incidents

Information to evaluate chemical incidents

Information to evaluate chemical incidents