Dopram

Give by IV infusion. Mix doxapram 400mg with 180mL of dextrose 5% or 10% or normal saline soln (concentration 2mg/mL). Initial rate: 1–2mg/minute, may increase to max 3mg/minute. Obtain arterial blood gases prior to treating and at least every half hour during the two hours of infusion to insure against the insidious development of CO2-retention and acidosis. If the blood gases show evidence of deterioration, the infusion of doxapram should be discontinued. Additional infusions beyond single max two hour administration period are not recommended.

Postanesthetic use: 0.5–1mg/kg for a single injection and at 5-minute intervals; max total dose: 2mg/kg. Or, may give as IV infusion at a rate of 5mg/minute until satisfactory response, then maintain at 1–3mg/minute; max total dose: 4mg/kg or approx. 300mg. Management of drug-induced CNS depression: Method One: Give priming dose of 1mg/kg (for mild depression) or 2mg/kg (for moderate depression) and repeat in 5 minutes. Repeat same dose every 1–2 hours until patient wakens. If relapse occurs, resume injections every 1–2 hours until arousal sustained, or total max (3g) is given. After max dose has been given, allow patient to sleep until 24 hours have elapsed from first inj using assisted or automatic respiration if necessary. Repeat following day until patient breathes spontaneously and sustains desired level of consciousness, or until max (3g) is given. Failure to response may indicate the need for neurologic evaluation. Method Two: Give priming dose as in Method One. If patient wakens, watch for relapse; if no response, continue general supportive treatment for 1–2 hours and repeat priming dose. If some respiratory stimulation occurs, give 1–2mg/kg/hr (for mild depression) or 2–3mg/kg/hr (for moderate depression) as an IV infusion. Discontinue if patient begins to waken or at end of 2 hours. Continue supportive treatment for ½–2 hours and repeat the second step. For both indications: Do not exceed 3g/day.