20 . March , 2019 - Wednesday
Check todays hot topics or new products

Find a Drug: Advanced

Please Sign in or Register

All about: Doxapram Hydrochloride

Big Image Pronouncation: (DOX-uh-pram HIGH-droe-KLOR-ide)
Class: Analeptic

Trade Names:
Dopram
- Injection 20 mg/mL

Mechanism of Action

Pharmacology

Increases depth of respirations (tidal volume) by stimulating respiratory center in CNS; respiratory rate may increase slightly. May elevate BP by increasing cardiac output. Respiratory depression from opiates is reversed without affecting pain relief.

Pharmacokinetics

Metabolism

Extensively metabolized.

Elimination

Metabolites and a small amount of unchanged drug excreted in urine. The t ½ is 2.4 to 4.1 h.

Onset

20 to 40 sec.

Peak

1 to 2 min.

Duration

5 to 12 min.

Indications and Usage

Stimulate deep breathing in postoperative patients; reversal of respiratory depression caused by anesthesia (other than muscle relaxants) or drug overdose; temporary measure for acute respiratory failure in patients with COPD who are not undergoing mechanical ventilation.

Contraindications

Use in newborns (contains benzyl alcohol); seizures; muscle paresis; epilepsy or other convulsive states; flail chest; head injury; pneumothorax; acute asthma; pulmonary fibrosis; other conditions that restrict chest wall, respiratory muscles or alveolar expansion; severe hypertension; cerebrovascular accident; proven or suspected pulmonary embolism; mechanical obstruction; cerebral edema; CV impairment; uncompensated heart failure; severe coronary artery disease; hypersensitivity to any component of the product.

Dosage and Administration

Anesthesia-induced Respiratory Depression
Adults

Max daily dose is 3 g. Bolus IV injection 0.5 to 1 mg/kg (single dose not to exceed 1.5 mg/kg). Can be given as multiple IV injections every 5 min (not to exceed total dose of 2 mg/kg).

IV infusion Initial rate 5 mg/min until satisfactory respiratory response is noted. Maintenance rate: 1 to 3 mg/min. Max total infusion dose is 4 mg/kg.

Drug-induced CNS Depression
Adults

Max daily dose is 3 g. Bolus IV injection Priming dose is 1 to 2 mg/kg (mild to moderate). Repeat in 5 min. Depending on response, may give every 1 to 2 h until patient awakens. Intermittent IV infusion Priming dose is 1 to 2 mg/kg (mild to moderate). If respirations improve, give by IV infusion at 1 to 3 mg/min. Discontinue after 2 h or if patient awakens.

Acute Hypercapnia from COPD
Adults

IV infusion 2 mg/mL with initial rate of 1 to 2 mg/min; may increase to max 3 mg/min; discontinue after 2 h.

Storage/Stability

Store vials at controlled room temperature (59° to 86°F).

Drug Interactions

Aminophylline, theophylline

May increase skeletal muscle activity, agitation, and hyperactivity.

Cyclopropane, enflurane, halothane

To prevent arrhythmias, wait at least 10 min after stopping these anesthetics before giving doxapram.

MAOIs, sympathomimetics

Increased risk of hypertension.

Muscle relaxants

Residual effects may be temporarily masked by doxapram.

Incompatibility

Do not add to or give with alkaline solutions such as aminophylline, furosemide, thiopental, or sodium bicarbonate.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Arrhythmias; chest pain; increased BP; lowered T-waves; phlebitis; tachycardia; tightness in chest; variations in heart rate.

CNS

Apprehension; bilateral Babinski; clonus; disorientation; dizziness; hallucination; headache; hyperactivity; increased reflexes; involuntary movements; muscle spasticity and fasciculations; paresthesia; pyrexia; seizures.

EENT

Pupillary dilation.

GI

Desire to defecate; diarrhea; nausea; vomiting.

Genitourinary

Elevation of BUN; urinary incontinence and retention.

Hematologic

Hemolysis (with rapid infusion).

Respiratory

Bronchospasm; cough; dyspnea; hiccoughs; hyperventilation; laryngospasm; rebound hypoventilation; tachypnea.

Miscellaneous

Feelings of warmth; flushing; pruritus; sweating.

Precautions

Pregnancy

Category B .

Lactation

Undetermined.

Children

Safety and efficacy not established in children younger than 12 yr of age. Doxapram contains benzyl alcohol, which has been associated with fatal gasping syndrome in premature infants.

COPD patients

Do not increase infusion rate in severely ill patients; drug may increase work of breathing.

Drug-induced CNS and respiratory depression

Used as adjunct to supportive care.

Postanesthesia

Do not use as antidote for opiates or neuromuscular blockers.

Overdosage

Symptoms

Severe hypertension, tachycardia, hyperactive reflexes, seizures.

Patient Information

  • Advise patient or caregiver that medication will be prepared and administered by health care professionals in a intensive care setting with close monitoring.

Recent Drug Updates at DrugIndexOnline:





Actos Actos
Generic Name: Pioglitazone (PYE-oh-GLI-ta-zone) Brand Name: ActosThiazolidinedione antidiabetics such as Actos may cause or worsen heart failure in some patients. Tell your doctor if you have a history of heart failure. Actos should not be used to treat patients with moderate to severe heart f more...

Amoxapine Amoxapine
Some commonly used brand names are: In the U.S.— Anafranil 3 Asendin 2 Aventyl 7 Elavil 1 Endep 1 Norfranil 6 Norpramin 4 Pamelor 7 Sinequan 5 Surmontil 9 Tipramine 6 Tofranil 6 Tofranil-PM 6 Vivactil 8 In Canada— Anafranil 3 Apo-Amitriptyline 1 Apo-Imipramine 6 Apo-Trimip 9 Asend more...

Bupropion Bupropion
Some commonly used brand names are: In the U.S.— Wellbutrin Wellbutrin SR Wellbutrin XL Zyban In Canada— Wellbutrin SR Zyban Another commonly used name is amfebutamone . Category Antidepressant Smoking cessation adjunct Description Bupropion (byoo-PROE-pee-on) is used to more...

Fenoterol Fenoterol
Some commonly used brand names are: In the U.S.— Adrenalin Chloride 3 Airet 1 Alupent 8 Arm-a-Med Isoetharine 6 Arm-a-Med Metaproterenol 8 Asthmahaler Mist 3 AsthmaNefrin 3 Beta-2 6 Brethaire 12 Bronkaid Mist 3 Bronkaid Suspension Mist 3 Bronkometer 6 Bronkosol 6 Dey-Lute Isoetharine 6 De more...

Histinex HC Histinex HC
Generic Name: chlorpheniramine, hydrocodone, and phenylephrine (klor feh NEER ah meen, hye droe KOE dohn, feh nill EH frin) Brand Names: Atuss MS, Chemdal HD, Chemtussin HC, Chlorgest HD, Chlorphen HD, Comtussin HC, Ditussin-HC, Duradal HD, Endagen-HD, Enditussin-HD, Endotuss-HD, Enplus-H more...

Iromin G Iromin G
Generic Name: multivitamins with iron (mull tee VYE tah mins with i ron) Brand Names: Allbee-C 800 with Iron, Anemagen, Anemagen FA, Bugs Bunny with Iron Chewable, Chromatinic, Contrin, Dayalets Plus Iron, Diatx Fe, Equi-Roca Plus, Equicyte Plus, Fe-Tinic 150 Forte, Femiron Multi with Iro more...

Lortab 10/500 Lortab 10/500
Some commonly used brand names are: In the U.S.— Allay 4 Anexsia 5/500 4 Anexsia 7.5/650 4 Anolor DH 5 4 Bancap-HC 4 Capital with Codeine 1 Co-Gesic 4 Darvocet-N 50 7 Darvocet-N 100 7 DHCplus 3 Dolacet 4 Dolagesic 4 Duocet 4 E-Lor 7 Endocet 5 EZ III 1 Hycomed 4 Hyco-Pap 4 Hydrocet 4 Hydro more...

MiraLax MiraLax
Generic name: Polyethylene glycol Brand names: MiraLax Why is MiraLax prescribed? MiraLax is a remedy for constipation. It works by retaining water in the stool, softening it and increasing the frequency of bowel movements. It may take up to 2 to 4 days to work. Most important fact about MiraL more...