Doxapram Aminophylline

The third infant was given aminophylline orally and doxapram by intravenous infusion 5 days later cisapride was added to treat suspected gastro-esophageal reflux. The next day the infant had developed second-degree AV block, with a prolonged QT interval. Doxapram was withdrawn and sinus rhythm returned 36 hours later. 

Methylxanthines have a few valid therapeutic uses, including treatment of asthma and relief of dyspnea (see Antiasthmatic agents). The CNS stimulatory effects are also utilized for the treatment of the prolonged apnea that may be observed in premature infants. Theophylline may be combined with doxapram (13) for this use (20). The methylxanthine most widely used therapeutically is theophylline, although caffeine may also be used. For parenteral administration, a salt of theophylline is employed. There are several salts available, including theophylline ethylenediamine (aminophylline [317-34-0]) and oxtriphylline (choline theophyllinate). Other synthetic xanthines that are used include dyphylline [479-18-5] and enprofylline [410784)2-8] (21). Caffeine is obtained in pure form from tea waste, from the manufacture of caffeine coffee, and by total synthesis (22,23). 

Intravenous theophylline does not affect the pharmaeokinetics of doxapram given to treat apnoea in premature infants. No adjustment of the dosage of doxapram is needed in the presence of theophylline. However, the manufaeturers of doxapram say that there may be an interaction between doxapram and aminophylline or theophylline, which is manifested by agitation and increased skeletal muscle activity. Care should therefore be taken if these drugs are used together. ... 

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