DOXAPRAM REVERSAL OF RESPIRATORY-FAILURE IN A PATIENT REFUSING ASSISTED VENTILATION

A 75-year-old man with severe chronic obstructive pulmonary disease an d epistaxis experienced progressive respiratory failure after receivin g an injection of meperidine and hydroxyzine in preparation for nasal packing. The patient and his family refused endotracheal intubation; d espite aggressive medical care, he continued to deteriorate toward an expected fatal outcome. An IV infusion of doxapram hydrochloride at 2 mg/min rapidly reversed his downhill course and hypercarbic coma. This case illustrates the potential usefulness of doxapram in the emergenc y setting. The mechanism of action, indications, dosing methods, and p otential side effects of this agent are discussed.