Abstract
Doxapram (Dox) has been recently used in the treatment of apnea of the newborn. Currently Dox is given by continuous I.V. low dose infusion; this usually implies a slow onset of action. A bolus infusion as a loading dose should accelerate this onset of action, and in theory repeated boluses could be used for administration. However, increases in blood pressure (BP) have been identified when a continuous I.V. infusion is used. The objective of this study was to define the changes in BP following bolus doses of Dox: 1, 2.5, 5 and 10mg/kg given over 1 min. Seven lambs were studied at 2 and at 15 days of age. After 1 mg/kg, 2 of the 7 two-day old lambs had no change in BP, the 5 others had a transient (<1 min) increase of a maximum of 10 mmHg from baseline; at 15 days of age, 2 had no change in BP, 2 had an increase of 5 to 10 mmHg (<1 min) and 3 had an increase of 10 to 20 mmHg (<2 min). After 2.5 mg/kg a maximum increase of 15 mmHg (<30 sec) was seen in 2 of the 2 day old lambs and in the 15 day old lambs a maximum increase of 30 mmHg (<1 min) was seen in 1 of the 7 lambs. For doses of 5 and 10 mg/kg the same magnitude of increase was seen but for a longer duration (5 to 30 minutes). In summary, only a transient mild increase in BP was seen with a rapid (1 min) bolus dose of 2.5 mg/kg or less of Dox. The safety of even these apparently small increases in BP is not yet known. Further, the effect of a less rapid infusion rate needs to be determined.
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Blanchard, P., Hobbs, S., Aranda, J. et al. BLOOD PRESSURE CHANGES AFTER BOLUS INFUSION OF DOXAPRAM IN NEWBORN LAMBS. Pediatr Res 21 (Suppl 4), 232 (1987). https://doi.org/10.1203/00006450-198704010-00396
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DOI: https://doi.org/10.1203/00006450-198704010-00396