Doxapram

Administration

• Type: Respiratory Stimulator
• Dosage Forms: INJ
• Routes of Administration: IV
• Common Trade Names: Dopram

Adult Dosing

Respiratory depression, postanesthesia

• Intermittent Injection
  • 0.5-1 mg/kg IV q5min prn
    • Max: 1.5 mg/kg/single dose, 2 mg/kg/total dose, 3g/24h
• Intermittent infusion
  • 0.5-1 mg/kg IV
    • Max: 4 mg/kg/dose, 3 g/24h

CNS depression, drug-induced

• Intermittent Injection
  • 1-2 mg/kg IV q1-2h prn
• Intermittent infusion
  • 1-3 mg/kg/h IV up to 2h

Acute hypercapnia, COPD-assoc.

• 1-3 mg/min IV up to 2h

Pediatric Dosing

Respiratory depression, postanesthesia

• Intermittent Injection
  • 0.5-1 mg/kg IV q5min prn
    • Max: 1.5 mg/kg/single dose, 2 mg/kg/total dose, 3g/24h
• Intermittent infusion
  • 0.5-1 mg/kg IV
    • Max: 4 mg/kg/dose, 3 g/24h

CNS depression, drug-induced

• Intermittent Injection
  • 1-2 mg/kg IV q1-2h prn
• Intermittent infusion
  • 1-3 mg/kg/h IV up to 2h

Special Populations

• Pregnancy Rating: C
• Lactation risk: No current data to asses risk

Renal Dosing

• Adult: Caution advised in significant impairment
• Pediatric: Caution advised in significant impairment

Hepatic Dosing

• Adult: Caution advised in significant impairment
• Pediatric: Caution advised in significant impairment

Contraindications

• Allergy to class/drug
• Concurrent mechanical ventilation
• Mechanical disorders of ventilation
• Seizure disorder
• Pulmonary embolism
• Head injury
• Stroke
• Cerebral edema
• Cardiovascular impairment, Heart failure, HTN

Adverse Reactions

Serious

• Bronchospasm, laryngospasm
• Arrhythmia
• HTN
• Seizure
• Hallucinations
• Hemolysis with rapid infusion

Common

• Fever, flushing, diaphoresis
• Pruritis, parasthesia
• Mydriasis
• Hallucination
• Headache, dizziness
• Hyperactivity, involuntary movements, muscle spasms
• Seizure
• Dyspnea, cough, hyperventilation, tachypnea
• Phlebitis
• Diarrhea, Urinary incontinence, urinary retention

Pharmacology

• Half-life: 3.4h
• Metabolism: Liver
• Excretion: Urine (<5% unchanged)

Mechanism of Action

• Acts on peripheral carotid chemoreceptors to stimulate respiration