Details About Generic Salt ::  Doxapram

Main Medicine Class:: CNS stimulant,Analeptic   

(DOX-uh-pram HIGH-droe-KLOR-ide)

Dopram

Class: CNS stimulant/Analeptic

 

Drugs Class ::

 Action 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.

Indications for Drugs ::

 Indications 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. Unlabeled use(s): Low doses of doxapram have been used in the treatment of apnea of prematurity when methylxanthines have failed.

Drug Dose ::

 Route/Dosage

Anesthesia-induced Respiratory Depression

ADULTS: 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 q 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. Maximum total infusion dose is 4 mg/kg.

Drug-induced CNS Depression

ADULTS: Maximum daily dose is 3 g. Bolus IV injection Priming dose is 2 mg/kg. Repeat in 5 min. Depending on response, may give q 1 to 2 hr. Intermittent IV infusion Priming dose is 2 mg/kg. If respirations improve, give by IV infusion at 1 to 3 mg/min. Discontinue after 2 hr 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 maximum of 3 mg/min; discontinue after 2 hr.

Contraindication ::

 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; CVA.

Drug Precautions ::

 Precautions

Pregnancy: Category B. Lactation: Undetermined. Children: Safety and efficacy not established in children < 12 yr. Doxapram contains benzl 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.

PATIENT CARE CONSIDERATIONS

Drug Side Effects ::

 Adverse Reactions

CV: Arrhythmias; tachycardia; increased BP; tightness in chest; chest pain; phlebitis. CNS: Seizures; paresthesia; increased reflexes; disorientation; dizziness; involuntary movements. EENT: Mydriasis. GI: Nausea; vomiting; diarrhea; desire to defecate. GU: Urinary incontinence and retention; elevation of BUN. HEMA: Hemolysis (with rapid infusion). RESP Laryngospasm; bronchospasm; rebound hypoventilation; cough; hiccoughs; dyspnea. OTHER: Flushing; feelings of warmth; sweating.

Drug Mode of Action ::  

 Action 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.

Drug Interactions ::

 Interactions

Cyclopropane, enflurane, halothane: To prevent arrhythmias, wait ³ 10 min after stopping these anesthetics before giving doxapram. MAO inhibitors, sympathomimetics: Increased risk of hypertension. Muscle relaxants: Residual effects may be temporarily masked by doxapram. Incompatibilities: Do not add to or give with alkaline solutions such as aminophylline, thiopental or sodium bicarbonate.

Drug Assesment ::

 Assessment/Interventions

• Obtain patient history, including drug history and any known allergies. Note any history of seizure disorder.
• Assess BP, pulse, deep tendon reflexes, neurologic status, ECG and ABGs before infusion and q 30 min during infusion.
• Institute seizure precautions before administering drug.
• Assess for poststimulation respiratory depression for ³ 30 min to 1 hr after patient becomes alert.
• Monitor respiratory status. Position patient on side in slightly elevated position to prevent aspiration.
• Monitor BP and deep tendon reflexes to prevent overdosage.
• Monitor patient’s CBC since rapid infusion can cause hemolysis.
• If ABGs deteriorate, notify physician immediately. Drug may need to be discontinued and mechanical ventilation started.
• Check infusion site regularly for extravasation, skin irritation and signs of thrombophlebitis.

OVERDOSAGE: SIGNS & SYMPTOMS   Severe hypertension, tachycardia, hyperactive reflexes or seizures

Drug Storage/Management ::

 Administration/Storage

• Ensure that patent airway has been established before administration.
• Do not give in conjunction with mechanical ventilation.
• Have readily available oxygen, IV barbiturates (eg, Valium) and resuscitative equipment.
• Allow 10 min after administration of anesthetic before starting infusion.
• Rotate injection sites to avoid skin irritation.
• For intermittent infusion, dilute 250 mg in 250 ml of D5W, D10W or 0.9% normal saline for concentration of 1 mg/ml. Dilute 400 mg in 180 ml of IV fluid for 2 mg/ml concentration.
• Store at room temperature.

Drug Notes ::

 Patient/Family Education

• Instruct patient/family to notify physician immediately if shortness of breath worsens.

Disclaimer ::

The Information available on this site is for only Informational Purpose , before any use of this information please consult your Doctor .Price of the drugs indicated above may not match to real price due to many possible reasons may , including local taxes etc.. These are only approximate indicative prices of the drug.