Doxapram

Indications
 Intravenous
Postoperative respiratory depression
Adult: Initially, 0.5-1.5 mg/kg given via IV inj over at least 30 sec. May repeat hrly, if necessary. Alternatively, it can be given via IV infusion at an initial rate of 2-5 mg/minute, may reduce to 1-3 mg/minute according to patient's response. Max total: 4 mg/kg.
Intravenous
Acute respiratory failure
Adult: 1.5-4 mg/minute by IV infusion.
Contraindications
 Severe heart disease and hypertension; epilepsy, cerebral oedema, hyperthyroidism, ischaemic heart disease, acute severe asthma, convulsive disorders, phaeochromocytoma, cerebrovascular accident, head injury, physical obstruction of the airway.
Warnings / Precautions
 Heart diseases, hepatic or renal impairment. Monitor BP, pulse rate and deep tendon reflexes. Rapid infusion may result in haemolysis. Protect and maintain adequate airway.
Adverse Reactions
 Dyspnoea and other respiratory problems. Muscle involvement may range from fasciculations to spasticity or seizures. Headache, dizziness, confusion, hyperactivity, hyperpyrexia particularly in the genital or perineal regions. Nausea, vomiting, diarrhoea, problems with urination. Alterations of BP and various arrhythmias. Thrombophloebitis following extravasation.
Overdose Reactions
 Symptoms include hypertension, tachycardia, skeletal muscle hyperactivity, enhanced deep tendon reflexes, agitation, confusion, sweating, cough and dyspnoea. Monitor BP, pulse rate and deep tendon reflexes periodically. Management should be symptomatic.
Drug Interactions
 Pressor effects enhanced by sympathomimetics or MAOIs. Masks residual effects of muscle relaxants. Cardiac arrhythmias with anaesthetics known to sensitise the myocardium. Concurrent use with aminophylline may manifest agitation and increased skeletal muscle activity.
See Below for More doxapram Drug Interactions
Mechanism of Actions
 Doxapram is a central and respiratory stimulant which acts by stimulating the peripheral chemoreceptors and central respiratory centers. At higher doses, stimulation of the other parts of the brain and spinal cord occurs. Doxapram also has pressor action and may increase catecholamine release. It improves respiratory depression induced by opioids without affecting analgesia.
Distribution: Rapidly distributed into the tissues after IV admin.
Metabolism: Extensive first-pass effect after IV inj.
Excretion: Metabolites and a small amount of unchanged drug are excreted via bile to the faeces.
Storage Conditions
 Intravenous: Store at 15-30°C.
ATC Classification
 R07AB01 - doxapram ; Belongs to the class of respiratory stimulants. Used in treatment of respiratory diseases.
Storage
 Intravenous: Store at 15-30°C.
Available As
  • Doxapram 20 mg

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