Doxapram

Doxapram hydrochloride (marketed as Dopram, Stimulex or Respiram) is a respiratory stimulant. Administered intravenously, doxapram stimulates an increase in tidal volume, and respiratory rate.

Doxapram
Clinical data
Routes of
administration		Intravenous
ATC code
Legal status
Legal status
  • In general: ℞ (Prescription only)
Identifiers
  • 1-ethyl-4- (2-morpholin-4-ylethyl)- 3,3-diphenyl-pyrrolidin-2-one
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.005.653
Chemical and physical data
FormulaC24H30N2O2
Molar mass378.516 g·mol−1
3D model (JSmol)
  • O=C4N(CC)CC(CCN1CCOCC1)C4(c2ccccc2)c3ccccc3
  • InChI=1S/C24H30N2O2/c1-2-26-19-22(13-14-25-15-17-28-18-16-25)24(23(26)27,20-9-5-3-6-10-20)21-11-7-4-8-12-21/h3-12,22H,2,13-19H2,1H3 checkY
  • Key:XFDJYSQDBULQSI-UHFFFAOYSA-N checkY
  (verify)

Mechanism of action
photograph of a vial of doxapram
A vial of doxapram

Doxapram stimulates chemoreceptors in the carotid bodies of the carotid arteries, which in turn, stimulates the respiratory centre in the brain stem.

Appearance

Doxapram is a white to off-white, odorless, crystalline powder that is stable in light and air. It is soluble in water, sparingly soluble in alcohol and practically insoluble in ether. Injectable products have a pH from 3.5-5. Benzyl alcohol or chlorobutanol is added as a preservative agent in the commercially available injections.

Uses

Doxapram is used in intensive care settings to stimulate the respiratory rate in patients with respiratory failure. It may be useful for treating respiratory depression in patients who have taken excessive doses of drugs such as buprenorphine or fentanyl analogues which may fail to respond adequately to treatment with naloxone.[1]

It is equally as effective as pethidine in suppressing shivering after surgery.[2]

Doxapram has been used as an anesthetic reversal agent when taking care of captive sharks but it must be used with caution since "animals can be extremely excitatory and dangerous under the influence of this drug".[3]

Side effects

Side effects include high blood pressure, panic attacks, rapid heart rate, tremor, sweating, and vomiting. Convulsions have been reported. Its use is relatively contraindicated in people with coronary heart disease, epilepsy, and high blood pressure. It is also contraindicated in newborns and small children, mainly due to the presence of benzyl alcohol, which is included as a preservative.

See also

References
  1. Buprenorphine Drug Data Sheet
  2. Singh P, Dimitriou V, Mahajan RP, Crossley AW (November 1993). "Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering". British Journal of Anaesthesia. 71 (5): 685–8. doi:10.1093/bja/71.5.685. PMID 8251281.
  3. Smith, M.F.L.; Ohio Biological Survey (2017). The Elasmobranch Husbandry Manual II: Recent Advances in the Care of Sharks, Rays and Their Relatives. Ohio Biological Survey. p. 292. Retrieved 2022-03-30.
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