Doxapram

How it works

It stimulates respiration through an action on peripheral chemoreceptors and, at higher doses, the central respiratory centres, increasing tidal volume and respiratory rate. The effect is brief, reflecting its short duration of action.

Prescribing in practice

• It has a narrow margin of safety and can cause agitation, hypertension, arrhythmias, and convulsions, so it must be given with continuous cardiorespiratory monitoring and is contraindicated in severe hypertension, epilepsy, and obstructive airways disease with severe airflow limitation.
• It is unsuitable where the increased work of breathing cannot be sustained, such as severe airflow obstruction or exhaustion.
• Use with great caution alongside other CNS stimulants and where coronary artery disease is present.

Monitoring

Maintain continuous monitoring of blood pressure, heart rhythm, oxygenation, and blood gases during the infusion.

Counselling the patient

• This is a hospital-only treatment given by drip under close observation.
• Staff will watch your breathing, heart, and blood pressure throughout.
• Tell staff at once if you feel agitated, breathless, or have palpitations.

Evidence & guidelines

Doxapram retains a limited specialist role as a respiratory stimulant in acute ventilatory failure when ventilatory support is not appropriate, used with intensive monitoring.