Doxapram
{{short description|Medication used for stimulating respiration}}
{{more citations needed|date=March 2025}}
{{drugbox
| verifiedrevid = 461091361
| IUPAC_name = 1-ethyl-4- (2-morpholin-4-ylethyl)- 3,3-diphenyl-pyrrolidin-2-one
| image = Doxapram.svg
| width = 201
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 3044
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = 94F3830Q73
| smiles = O=C4N(CC)CC(CCN1CCOCC1)C4(c2ccccc2)c3ccccc3
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 1754
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 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
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = XFDJYSQDBULQSI-UHFFFAOYSA-N
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 309-29-5
| ATC_prefix = R07
| ATC_suffix = AB01
| ATC_supplemental =
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 681848
| PubChem = 3156
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB00561
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D07873
| C = 24
| H = 30
| N = 2
| O = 2
| bioavailability =
| protein_bound =
| metabolism =
| elimination_half-life =
| tradename = Dopram, Stimulex, Respiram
| pregnancy_category =
| legal_status = Rx only
| routes_of_administration = Intravenous
}}
Doxapram is a respiratory stimulant, or analeptic. Administered intravenously, doxapram stimulates an increase in tidal volume, and respiratory rate.{{Citation needed|date=March 2025}}
Medical 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 opioids which may fail to respond adequately to treatment with naloxone.{{cite web |date= |title=Buprenorphine Drug Data Sheet |url=http://www.naabt.org/documents/packageinsert.pdf |work=Reckitt Benckiser Pharmaceuticals, Inc.}}
It is equally as effective as pethidine in suppressing shivering after surgery.{{cite journal |vauthors=Singh P, Dimitriou V, Mahajan RP, Crossley AW |date=November 1993 |title=Double-blind comparison between doxapram and pethidine in the treatment of postanaesthetic shivering |journal=British Journal of Anaesthesia |volume=71 |issue=5 |pages=685–688 |doi=10.1093/bja/71.5.685 |pmid=8251281 |doi-access=free}}
Doxapram has been used as a reversal agent after general anesthesia in captive sharks and rays, but it must be used with caution, as the animals can become excitatory as a side effect.{{cite book |url=https://books.google.com/books?id=TlJhzgEACAAJ |title=The Elasmobranch Husbandry Manual II: Recent Advances in the Care of Sharks, Rays and Their Relatives |vauthors=Smith MF |publisher=Ohio Biological Survey |year=2017 |page=292 |access-date=2022-03-30}}
Side effects
Side effects of doxapram include high blood pressure, anxiety, rapid heartbeat, tremor, sweating, and vomiting. Convulsions have been reported. Its use is relatively contraindicated in people with coronary artery disease, epilepsy, and high blood pressure. It is also contraindicated in newborns and small children, mainly due to the presence of benzyl alcohol, which is included as a preservative.{{Citation needed|date=March 2025}}
Mechanism of action
Doxapram stimulates chemoreceptors in the carotid bodies of the carotid arteries, which in turn, stimulates the respiratory center in the brainstem.{{Citation needed|date=March 2025}}
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 commercially available preparations.{{Citation needed|date=March 2025}}
See also
- Pentethylcyclanone (similar structure)
References
{{Reflist}}
{{Respiratory stimulants}}