DOXAPRAM

Doxapram is an analeptic, used for improving breathing in patients after surgery or overdose of certain medicines. It works by stimulating the breathing center of the brain by altering the natural chemicals (neurotransmitters) in the brain. It is also used to treat chronic lung disease associated with excessive carbon dioxide in the blood.

It is used in:

  • Post-anesthesia: stimulate respiration in drug-induced post-anesthesia respiratory depression
  • Drug-induced respiratory rate depression
  • Chronic pulmonary disease associated with hypercapnia
  • cough
  • difficulty of breathing
  • shortness of breath
  • headache
  • dizziness
  • apprehension
  • hypertension
  • flushing or redness
  • sweating
  • nausea and vomiting
  • diarrhea
  • urinary retention
  • muscle spasticity

Precautions

  • An adequate airway is essential and airway protection should be considered since doxapram may stimulate vomiting.
  • Recommended dosages of doxapram should be employed and maximum total dosages should not be exceeded. In order to avoid side effects, it is advisable to use the minimum effective dosage.
  • Monitoring of the blood pressure, pulse rate, and deep tendon reflexes is recommended to prevent overdosage.
  • Vascular extravasation or use of a single injection site over an extended period should be avoided since either may lead to thrombophlebitis or local skin irritation.
  • Rapid infusion may result in hemolysis.
  • Lowered pCO2 induced by hyperventilation produces cerebral vasoconstriction and slowing of the cerebral circulation.
  • There is a risk that doxapram will produce adverse effects (including seizures) due to general central nervous system stimulation. Muscle involvement may range from fasciculation to spasticity. Anticonvulsants such as intravenous short-acting barbiturates, along with oxygen and resuscitative equipment should be readily available to manage overdosage manifested by excessive central nervous system stimulation. Slow administration of the drug and careful observation of the patient during administration and for some time subsequently are advisable. These precautions are to assure that the protective reflexes have been restored and to prevent possible post-hyperventilation or hypoventilation.
  • Doxapram should be administered cautiously to patients receiving sympathomimetic or monoamine oxidase inhibiting drugs, since an additive pressor effect may occur.
  • Blood pressure increases are generally modest but significant increases have been noted in some patients. Because of this, doxapram is not recommended for use in patients with severe hypertension.
  • Cardiovascular effects may include various dysrhythmias. Patients receiving doxaprom should be monitored for disturbance of their cardiac rhythm.
  • If sudden hypotension or dyspnea develops, doxapram should be stopped.
  • Doxapram should be administered with caution to patients with significantly impaired hepatic or renal function as a reduction in the rate of metabolism or excretion of metabolites may alter the response.

 

Interactions

Some MEDICINES MAY INTERACT with doxapram. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Aminophylline
  • monoamine oxidase (MAO) inhibitors (eg, phenelzine)
  • sympathomimetics (eg, phenylephrine)
  • theophylline because the side effects of doxapram may be increased

If OVERDOSE is suspected:

Contact your local poison control center, or emergency room immediately. Symptoms may include agitation; confusion; cough; difficulty breathing; fast heartbeat; high blood pressure; muscle hyperactivity; reflex changes; sweating.

 

Proper storage of doxapram:

Doxapram is usually handled and stored by a health care provider. If you are using doxapram at home, store doxapram as directed by your pharmacist or health care provider.

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