The Ventilatory Effects of Doxapram in Normal Man

Calverley, PM; Robson, R. H.; Wraith, P. K.; Prescott, L. F.; Flenley, D. C.

doi:10.1042/cs0650065

Cited by 38 publications

(18 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[111][112][113][114] The relative importance of these actions in humans is unknown. [115] The physiologic effects of doxapram in the premature infant have been evaluated by Barrington et al [116] Following continuous infusions of doxapram at 2 or 2.5 mg/kg/h, there were significant increases in minute ventilation, tidal volume, mean inspiratory flow, and airway pressure, with reduction in spells of apnea suggesting an increase in the respiratory center output.…”

Section: Mechanism Of Actionmentioning

confidence: 99%

Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

View full text Add to dashboard Cite

In the last decade, knowledge regarding the neurodevelopment and functional aspects of the respiratory centers during postnatal maturation has increased substantially. However, an increase in such knowledge has not provided a basis for change in practice. The diagnosis of apnea of prematurity (AOP) is one of exclusion. All causes of secondary apnea must be ruled out before initiating treatment for AOP. Treatment will depend on the etiology as well as effectiveness and tolerability of the treatment by the patient. The primary goal of any treatment of AOP is to prevent the frequency of apnea lasting >20 seconds, and/or those that are shorter, but associated with cyanosis and bradycardia. The clinical management of AOP is not much different today than it was two decades ago, with pharmacologic and nonpharmacologic treatment options remaining the mainstay of therapy. Methylxanthines are still the most widely used pharmacologic agents. Due to the wider therapeutic index of caffeine and ease of once daily administration, it should be the preferred agent. Doxapram, or nonpharmacologic treatment measures such as nasal continuous positive airway pressure, may be considered in infants who are unresponsive to methylxanthine treatment alone. Treatment should be continued until there is complete resolution of apnea, and for some time thereafter. The choice of method for weaning treatment remains one of individual physician preference. Discharge from hospital after apnea requires close monitoring and some infants will require home apnea monitors. The decision to provide a home apnea monitor should be individualized for each patient, depending on the effectiveness of treatment and clinical response.

show abstract

Section: Mechanism Of Actionmentioning

confidence: 99%

Treatment of Apnea of Prematurity

Bhatt‐Mehta

Schumacher

2003

Pediatric Drugs

View full text Add to dashboard Cite

show abstract

“…This drug is a potent stimulus to breathing in healthy individuals [33] but appears inferior to noninvasive positive pressure ventilation in COPD patients [34].…”

Section: Maintaining Gas Exchangementioning

confidence: 99%

Respiratory failure in chronic obstructive pulmonary disease

Calverley¹

2003

European Respiratory Journal

104

View full text Add to dashboard Cite

Respiratory failure in chronic obstructive pulmonary disease. P.M.A. Calverley. #ERS Journals Ltd 2003. ABSTRACT: Respiratory failure is still an important complication of chronic obstructive pulmonary disease (COPD) and hospitalisation with an acute episode being a poor prognostic marker. However, other comorbid conditions, especially cardiovascular disease, are equally powerful predictors of mortality.The physiological basis of acute respiratory failure in COPD is now clear. Significant ventilation/perfusion mismatching with a relative increase in the physiological dead space leads to hypercapnia and hence acidosis. This is largely the result of a shift to a rapid shallow breathing pattern and a rise in the dead space/tidal volume ratio of each breath. This breathing pattern results from adaptive physiological responses which lessen the risk of respiratory muscle fatigue and minimise breathlessness.Treatment is directed at reducing the mechanical load applied to each breath, correcting specific precipitating factors, e.g. bacterial infection, and maintaining gas exchange. Both bronchodilators and oral corticosteroids can improve spirometric results in exacerbations of COPD and should be routinely offered to patients with respiratory failure. Controlled oxygen is still not always prescribed appropriately and high inspired oxygen concentrations can lead to severe acidosis by either worsening ventilation/perfusion mismatching and/or inducing a degree of hypoventilation. Ventilatory support using noninvasive ventilation has revolutionised the approach to these patients.Acute respiratory failure due to chronic obstructive pulmonary disease remains a common medical emergency that can be effectively managed. More attention should be focused on the prevention of these episodes and identifying the factors which cause early relapse. Eur Respir J 2003; 22: Suppl. 47, 26s-30s.

show abstract

“…Doxapram, a respiratory stimulant primarily used in anesthesiology, is thought to stimulate the carotid body chemoreceptors, thereby increasing respiratory rate (Folgering et al, 1981). It requires only minimal injection volumes, has a rapid onset of action, has minimal side effects (Winnie, 1973), and does not appreciably cross the blood-brain barrier or affect vascular flow (Folgering et al, 1981;Burki, 1984;Calverley et al, 1983). Doxapram has been shown to increase anxiety behaviors in a rodent model of panic (Sullivan et al, 2003;Choi et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

The effect of doxapram on brain imaging in patients with panic disorder

Garakani

Buchsbaum

Newmark

et al. 2007

European Neuropsychopharmacology

View full text Add to dashboard Cite

Administration of doxapram hydrochloride, a respiratory stimulant, is experienced by panic disorder patients to be similar to panic attacks but has reduced emotional effect in normal volunteers thus providing a laboratory model of panic for functional imaging. Six panic patients and seven normal control subjects underwent positron emission tomography with 18F-deoxyglucose imaging after a single-blinded administration of either doxapram or a placebo saline solution. Saline and doxapram were administered on separate days in counterbalanced order. Patients showed a greater heart rate increase on doxapram from saline than controls, indicating differential response. On the saline placebo day, patients had greater prefrontal relative activity than controls. In response to doxapram, patients tended to decrease prefrontal activity more than controls, and increased cingulate gyrus and amygdala activity more than controls. This suggests that panic disorder patients activate frontal inhibitory centers less than controls which may lower the threshold for panic.

show abstract

The Ventilatory Effects of Doxapram in Normal Man

Cited by 38 publications

References 16 publications

Treatment of Apnea of Prematurity

Treatment of Apnea of Prematurity

Respiratory failure in chronic obstructive pulmonary disease

The effect of doxapram on brain imaging in patients with panic disorder

Contact Info

Product

Resources

About