DIGOXIN

Clear to white crystals or white crystalline powder. Odorless. Used as a cardiotonic drug. (EPA, 1998)

none

No rapid reaction with air. No rapid reaction with water.

Avoid light. (EPA, 1998)

Material is a digitalis glycoside. Ingestion can cause death. Material is considered super toxic; probable human oral lethal dose is less than 5 mg/kg, a taste (less than 7 drops) for a 70 kg (150 lb.) person. Persons at risk include those taking drugs for thyroid and renal diseases. Quinidine and diuretics taken concurrently with digoxin can be hazardous. It should be used with extreme care during pregnancy and in nursing mothers. (EPA, 1998)

No information available.

• Alcohols and Polyols
• Esters, Sulfate Esters, Phosphate Esters, Thiophosphate Esters, and Borate Esters
• Ethers
• Hydrocarbons, Aliphatic Unsaturated

Use caution: Liquids with this reactive group classification have been known to react with the absorbents listed below.

• Cellulose-Based Absorbents
• Dirt/Earth

Excerpt from ERG Guide 154 [Substances - Toxic and/or Corrosive (Non-Combustible)]:

IMMEDIATE PRECAUTIONARY MEASURE: Isolate spill or leak area in all directions for at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids.

SPILL: Increase the immediate precautionary measure distance, in the downwind direction, as necessary.

FIRE: If tank, rail tank car or highway tank is involved in a fire, ISOLATE for 800 meters (1/2 mile) in all directions; also, consider initial evacuation for 800 meters (1/2 mile) in all directions. (ERG, 2024)

(Non-Specific -- Medicines, Solid, Poison B) Extinguish fire using agent suitable for type of surrounding fire; material burns with difficulty. Use water in flooding quantities as fog. Use alcohol foam, carbon dioxide, or dry chemical. (EPA, 1998)

(Non-Specific -- Medicines, Solid, Poison B) Avoid breathing dusts, and fumes from burning materials. Keep upwind. Avoid bodily contact with the material. Wash away any material which may have contacted the body with copious amounts of water or soap and water. (EPA, 1998)

For emergency situations, wear a positive pressure, pressure-demand, full facepiece self-contained breathing apparatus (SCBA) or pressure- demand supplied air respirator with escape SCBA and a fully-encapsulating, chemical resistant suit. (EPA, 1998)

No information available.

Warning: Digoxin may cause death or permanent injury after a very sort exposure. Effects may be delayed up to 12 hours. Caution is advised. Vital signs should be monitored closely.

Signs and Symptoms of Digoxin Exposure: Acute digoxin ingestion may produce the following signs and symptoms: nausea, vomiting, headache, lethargy, drowsiness, confusion, slowed pulse, varying degrees of heart block, and heart arrhythmias. Coma, respiratory failure, and heart failure may also occur.

Emergency Life-Support Procedures: Acute exposure to digoxin may require decontamination and life support for the victims. Emergency personnel should wear protective clothing appropriate to the type and degree of contamination. Air-purifying or supplied-air respiratory equipment should also be worn, as necessary. Rescue vehicles should carry supplies such as plastic sheeting and disposable plastic bags to assist in preventing spread of contamination.

Inhalation Exposure:
1. Move victims to fresh air. Emergency personnel should avoid self-exposure to digoxin.
2. Evaluate vital signs including pulse and respiratory rate, and note any trauma. If no pulse is detected, provide CPR. If not breathing, provide artificial respiration. If breathing is labored, administer oxygen or other respiratory support.
3. Obtain authorization and/or further instructions from the local hospital for administration of an antidote or performance of other invasive procedures.
4. Transport to a health care facility.

Dermal/Eye Exposure:
1. Remove victims from exposure. Emergency personnel should avoid self-exposure to digoxin.
2. Evaluate vital signs including pulse and respiratory rate, and note any trauma. If no pulse is detected, provide CPR. If not breathing, provide artificial respiration. If breathing is labored, administer oxygen or other respiratory support.
3. Remove and isolate contaminated clothing as soon as possible.
4. If eye exposure has occurred, eyes must be flushed with lukewarm water for at least 15 minutes.
5. Wash exposed skin areas thoroughly with water.
6. Obtain authorization and/or further instructions from the local hospital for administration of an antidote or performance of other invasive procedures.
7. Transport to a health care facility.

Ingestion Exposure:
1. Evaluate vital signs including pulse and respiratory rate, and note any trauma. If no pulse is detected, provide CPR. If not breathing, provide artificial respiration. If breathing is labored, administer oxygen or other respiratory support.
2. Obtain authorization and/or further instructions from the local hospital for administration of an antidote or performance of other invasive procedures.
3. Vomiting may be induced with syrup of Ipecac. If elapsed time since ingestion of digoxin is unknown or suspected to be greater than 30 minutes, do not induce vomiting and proceed to Step
4. Ipecac should not be administered to children under 6 months of age. Warning: Ingestion of digoxin may result in sudden onset of seizures or loss of consciousness. Syrup of Ipecac should be administered only if victims are alert, have an active gag reflex, and show no signs of impending seizure or coma. If ANY uncertainty exists, proceed to Step
4. The following dosages of Ipecac are recommended: children up to 1 year old, 10 mL (1/3 oz); children 1 to 12 years old, 15 mL (1/2 oz); adults, 30 mL (1 oz). Ambulate (walk) the victims and give large quantities of water. If vomiting has not ccurred after 15 inutes, Ipecac may be readministered. Continue to ambulate and give water to the victims. If vomiting has not occurred within 15 minutes after second administration of Ipecac, administer activated charcoal.
4. Activated charcoal may be administered if victims are conscious and alert. Use 15 to 30 g (1/2 to 1 oz) for children, 50 to 100 g (1-3/4 to 3-1/2 oz) for adults, with 125 to 250 mL (1/2 to 1 cup) of water.
5. Promote excretion by administering a saline cathartic or sorbitol to conscious and alert victims. Children require 15 to 30 g (1/2 to 1 oz) of cathartic; 50 to 100 g (1-3/4 to 3-1/2 oz) is recommended for adults.
6. Rush to a health care facility. (EPA, 1998)

• ACYGOXIN
• 12BETA-HYDROXYDIGITOXIN
• CARD-20(22)-ENOLIDE, 3-((O-2,6-DIDEOXY-BETA-D-RIBO- HEXOPYRANOSYL-(HEXOPYRANOSYL-(1-4)-2,6-DIDEOXY-BETA-D-RIBO-HEXOPYRANOSYL)OXY)- 12,14-DIHYDROXY-,
• CHLOROFORMIC DIGITALIN
• CORDIOXIL
• DAVOXIN
• DIGACIN
• DIGITALIS GLYCOSIDE
• DIGITOXIN, 12BETA-HYDROXY-
• DIGOSIN
• DIGOXIN
• DILANACIN
• DIXINA
• HOMOLLE'S DIGITALIN
• LANACORDIN
• LANATILIN
• LANICOR
• LANOCARDIN
• LANOXIN
• ROUGOXIN
• SAROXIN
• VANOXIN