Key messages

• Respiratory stimulant effects are exhibited by a number of different classes of drugs, the most significant of which are the analeptics (doxapram and nikethamide), theophylline, and the triazine derivatives (almitrine bismesylate).

• The place of doxapram in respiratory failure remains contentious, but it may have a role where non-invasive mechanical support is impractical.

• Theophyllines have a theoretical role in the treatment of respiratory failure but await large-scale clinical trials in this context.

• Almitrine bismesylate is an orally active respiratory stimulant with potential in the treatment of both acute and chronic respiratory failure.

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