Home Drug Guide Doxapram Hydrochloride

Drug Guide

Generic Name

Doxapram Hydrochloride

Brand Names Dopram

Classification

Therapeutic: Respiratory Stimulant

Pharmacological: Central Nervous System Stimulant

FDA Approved Indications

  • Management of respiratory depression due to respiratory failure, especially in cases of apnea, postoperative respiratory depression, or drug overdose with respiratory depression.

Mechanism of Action

Doxapram stimulates the carotid chemoreceptors and the respiratory center in the medulla oblongata, resulting in increased respiratory drive and ventilatory rate.

Dosage and Administration

Adult: Initial dose: 5-10 mg administered intravenously over 20-30 seconds. Repeat at 30-second intervals if necessary, up to a maximum of 15 mg. Maintain as needed, not exceeding total dose of 20 mg per 24 hours.

Pediatric: The dosage varies based on age and weight; typically, 0.5 mg/kg IV as a single dose, repeated as necessary. Specific pediatric dosing should be guided by clinical judgment and age/weight.

Geriatric: Use with caution; dosage adjustments are often necessary due to increased sensitivity and comorbidities.

Renal Impairment: No specific adjustment; monitor closely for effectiveness and adverse effects.

Hepatic Impairment: No specific adjustment suggested, but caution is advised.

Pharmacokinetics

Absorption: Given IV directly into circulation, so absorption not a concern.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized hepatically, though specific pathways are not well characterized.

Excretion: Excreted primarily in urine as metabolites.

Half Life: Approximately 3-8 hours, depending on renal function.

Contraindications

  • Known hypersensitivity to doxapram or related compounds.
  • Uncontrolled hypertension or severe coronary artery disease.

Precautions

  • Use cautiously in patients with increased intracranial pressure, unstable cardiac conditions, or severe hypertension. Monitor blood pressure and cardiac status closely. Pregnant and lactating women: consult specific guidelines; use only if clearly needed.

Adverse Reactions - Common

  • Hypertension (Less common)
  • Tachycardia (Less common)
  • Nausea or vomiting (Common)
  • Anxiety or restlessness (Common)

Adverse Reactions - Serious

  • Seizures (Rare)
  • Arrhythmias (Rare)
  • Elevated blood pressure or hypertensive crisis (Rare)

Drug-Drug Interactions

  • Amphetamines or other CNS stimulants (risk of additive effects).
  • Sympathomimetic agents (potential for increased cardiovascular effects).

Drug-Food Interactions

  • No significant interactions identified.

Drug-Herb Interactions

  • Limited data; caution advised with herbal stimulants or adrenergic agents.

Nursing Implications

Assessment: Assess respiratory status before and during administration. Monitor blood pressure, heart rate, and neurologic status.

Diagnoses:

  • Impaired gas exchange related to respiratory depression.
  • Risk for hypertension or arrhythmias.

Implementation: Administer IV as prescribed; ensure resuscitation equipment is available. Monitor vital signs and respiratory function continuously.

Evaluation: Evaluate effectiveness by improvement in respiratory rate and blood gases; monitor for adverse reactions.

Patient/Family Teaching

  • Inform patient and family about the purpose of the drug, potential side effects, and importance of monitoring vital signs.
  • Advise them to report chest pain, irregular heartbeat, severe headache, or neurological changes immediately.

Special Considerations

Black Box Warnings: N/A

Genetic Factors: None specific.

Lab Test Interference: No known interference with laboratory tests.

Overdose Management

Signs/Symptoms: Severe hypertension, seizures, arrhythmias, or agitation.

Treatment: Supportive care, seizure management with anticonvulsants if necessary, and control of blood pressure. Hemodialysis is not effective for overdose removal.

Storage and Handling

Storage: Store at controlled room temperature (20°C to 25°C). Keep in a protected environment away from light.

Stability: Stable under recommended storage conditions for the shelf life as indicated in the product labeling.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.