PEDIATRICS Vol. 80 No. 1 July 1987, pp. 22-27
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Dose-Response Relationship of Doxapram in the Therapy for Refractory Idiopathic Apnea of Prematurity

Keith J. Barrington MB1, Neil N. Finer MD1, George Torok-Both PhD1, Fakhreddin Jamali PhD1, and Ronald T. Coutts PhD1

1 From the Division of Newborn Medicine, the Royal Alexandra Hospital, and the Department of Pediatrics and the Faculty of Pharmacy, University of Alberta, Edmonton, Alberta, Canada

Eighteen infants with idiopathic apnea of prematurity refractory to therapeutic levels of aminophylline were treated with incremental doses of doxapram beginning at 0.5 mg/kg/h. Continuous recording of heart rate, thoracic impedance, and transcutaneous Po2 demonstrated that 47% of the infants satisfied objective response criteria at the lowest dose, 53% responded at 1.0 mg/kg/h, 65% at 1.5 mg/kg/h, 82% at 2.0 mg/kg/h, and 89% at the highest allowed dose of 2.5 mg/kg/h. The mean serum doxapram concentration at the response dose was 2.9 ± 1.3 µg/mL, and all infants who responded had levels greater than 1.5 µg/mL. BP was significantly elevated at doses higher than 1.5 mg/kg/h (P < .05). Minute ventilation significantly increased and Pco2 significantly decreased as the doxapram dosage was increased (P = .02). Terminal elimination half-life was 9.9 ± 2.9 hours. When doxapram is used for treatment of refractory neonatal apnea the starting dosage should be no more than 0.5 mg/kg/h.

Key Words: apnea of prematurity • doxapram

Submitted on July 7, 1986
Accepted on October 23, 1986




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[Abstract] [Full Text] [PDF]