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Active ingredient: Doxapram - Brands, Medical Use, Clinical Data

Brands, Medical Use, Clinical Data

Drug Category

  • Central Nervous System Stimulants
  • Respiratory System Agents

Dosage Forms

  • Liquid
  • Solution

Brands / Synonyms

Dopram; Doxapram; Doxapram HCL; Doxapram hydrochloride; Stimulexin

Indications

For use as a temporary measure in hospitalized patients with acute respiratory insufficiency superimposed on chronic obstructive pulmonary disease.

Pharmacology

Doxapram is an analeptic agent (a stimulant of the central nervous system). The respiratory stimulant action is manifested by an increase in tidal volume associated with a slight increase in respiratory rate. A pressor response may result following doxapram administration. Provided there is no impairment of cardiac function, the pressor effect is more marked in hypovolemic than in normovolemic states. The pressor response is due to the improved cardiac output rather than peripheral vasoconstriction. Following doxapram administration, an increased release of catecholamines has been noted.

Mechanism of Action

Doxapram produces respiratory stimulation mediated through the peripheral carotid chemoreceptors.

Absorption

Not Available

Toxicity

Intravenous LD50 values in the mouse and rat were approximately 75 mg/kg and in the cat and dog were 40 to 80 mg/kg. Symptoms of overdosage are extensions of the pharmacologic effects of the drug. Excessive pressor effect, tachycardia, skeletal muscle hyperactivity, and enhanced deep tendon reflexes may be early signs of overdosage.

Biotrnasformation / Drug Metabolism

Not Available

Contraindications

Due to its benzyl alcohol content, doxapram injection is contraindicated in neonates.

Doxapram should not be used in patients with epilepsy or other convulsive disorders.

Doxapram is contraindicated in patients with mechanical disorders of ventilation such as mechanical obstruction, muscle paresis, flail chest, pneumothorax, acute bronchial asthma, pulmonary fibrosis or other conditions resulting in restriction of chest wall, muscles of respiration or alveolar expansion.

Doxapram is contraindicated in patients with evidence of head injury or cerebral vascular accident and in those with significant cardiovascular impairment, severe hypertension, or known hypersensitivity to the drug or any of the injection components.

Drug Interactions

Administration of doxapram to patients who are receiving sympathomimetic or monoamine oxidase inhibiting drugs may result in an additive pressor effect .

In patients who have received muscle relaxants, doxapram may temporarily mask the residual effects of muscle relaxant drugs.

In patients who have received general anesthesia utilizing a volatile agent known to sensitize the myocardium to catecholamines, administration of doxapram should be delayed until the volatile agent has been excreted in order to lessen the potential for arrhythmias, including ventricular tachycardia and ventricular fibrillation.

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