Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/12/12 13:54:10」(JST)

wiki en

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

Mechanism of Action

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 which may fail to respond adequately to treatment with naloxone.^[1]

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

Side effects

High blood pressure, panic attacks, tachycardia (rapid heart rate), tremor, sweating and vomiting may occur. Convulsions have been reported. It cannot be used in patients 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.

References

^ Buprenorphine Drug Data Sheet
^ Singh, P; Dimitriou, V; Mahajan, RP; Crossley, AW (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.

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 成人の術後肺合併症の発症を減少させるための戦略 strategies to reduce postoperative pulmonary complications in adults
2. 早産児における無呼吸のマネージメント management of apnea of prematurity

English Journal

Increase of Caffeine and Decrease of Corticosteroids for Extremely Low Birthweight Infants with Respiratory Failure from 1997 to 2011.

Gerull R, Manser H, Küster H, Arenz T, Nelle M, Arenz S.SourceDivision of Neonatology, University Children's Hospital Berne, Switzerland.
Acta paediatrica (Oslo, Norway : 1992).Acta Paediatr.2013 Sep 16. doi: 10.1111/apa.12419. [Epub ahead of print]
AIM: To compare treatment strategies for respiratory failure in extremely low birth weight (ELBW) infants in Germany in 1997 to Germany, Austria and Switzerland in 2011.METHODS: A detailed questionnaire about treatment strategies for ELBW infants was sent to all German centres treating ELBW infants
PMID 24102836

Repeated intravenous doxapram induces phrenic motor facilitation.

Sandhu MS, Lee KZ, Gonzalez-Rothi EJ, Fuller DD.SourceDepartment of Physical Therapy, College of Public Health and Health Professions, McKnight Brain Institute, University of Florida, P.O. Box 100154, 100 S. Newell Drive, Gainesville, FL 32610, USA.
Experimental neurology.Exp Neurol.2013 Sep 4;250C:108-115. doi: 10.1016/j.expneurol.2013.08.016. [Epub ahead of print]
Doxapram is a respiratory stimulant used to treat hypoventilation. Here we investigated whether doxapram could also trigger respiratory neuroplasticity. Specifically, we hypothesized that intermittent delivery of doxapram at low doses would lead to long-lasting increases (i.e., facilitation) of phre
PMID 24013015

Doxapram and hypokalaemia in very preterm infants.

Fischer C, Ferdynus C, Gouyon JB, Semama DS.SourceService de Pédiatrie, Centre Hospitalier Universitaire, Dijon, France.
Archives of disease in childhood. Fetal and neonatal edition.Arch Dis Child Fetal Neonatal Ed.2013 Sep;98(5):F416-8. doi: 10.1136/archdischild-2012-303089. Epub 2013 Feb 28.
BACKGROUND: We observed two preterm infants who developed severe hypokalaemia following doxapram. We therefore wished to review the possible association between doxapram and severe hypokalaemia.STUDY DESIGN: A retrospective study of preterm infants born before 32 weeks of gestation and hospitalised
PMID 23448699

Japanese Journal

低用量ドキサプラム投与の脳血流, 脳内酸素化指標に及ぼす影響

日本未熟児新生児学会雑誌 = Journal of Japan Society for Premature and Newborn Medicine 23(2), 65-71, 2011-06-15
NAID 10029414233

早産児無呼吸発作と神経学的予後に関する検討 : 第二報 : 重症無呼吸発作が3歳時・6歳時における身体発育・精神運動発達に与える影響の検討

日本未熟児新生児学会雑誌 = Journal of Japan Society for Premature and Newborn Medicine 22(2), 51-60, 2010-06-15
NAID 10026440554

早産児無呼吸発作と神経学的予後に関する検討 : 第一報 : 長期予後検討のための早産児無呼吸発作の実態把握

日本未熟児新生児学会雑誌 = Journal of Japan Society for Premature and Newborn Medicine 22(1), 89-96, 2010-02-15
NAID 10026440270

Related Pictures

★リンクテーブル★

リンク元	「ドキサプラム」
拡張検索	「doxapram hydrochloride hydrate」

「ドキサプラム」

Doxapram
Systematic (IUPAC) name
	1-ethyl-4- (2-morpholin-4-ylethyl)- 3,3-diphenyl-pyrrolidin-2-one
Clinical data
Pregnancy cat.	?
Legal status	?
Routes	Intravenous
Identifiers
CAS number	309-29-5
ATC code	R07AB01
PubChem	CID 3156
DrugBank	DB00561
ChemSpider	3044
UNII	94F3830Q73
KEGG	D07873
ChEBI	CHEBI:681848
ChEMBL	CHEMBL1754
Chemical data
Formula	C24H30N2O2
Mol. mass	378.507 g/mol
	SMILES O=C4N(CC)CC(CCN1CCOCC1)C4(c2ccccc2)c3ccccc3;
	InChI 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 ; Key:XFDJYSQDBULQSI-UHFFFAOYSA-N ;
(what is this?) (verify);