Notes

Respiratory stimulants are mainly used in patients with chronic airflow limitation who develop acute hypercapnic respiratory failure. Effects of doxapram are short-lived so infusion is necessary. After about 12h infusion the effects on ventilatory drive are reduced.

Naloxone may be used in respiratory depression due to opiate drugs. Since it reverses all opiate effects, it may be better to reverse respiratory depression with non-specific respiratory stimulants, leaving pain relief intact. It may need to be repeated when long acting opiates are involved.

As most benzodiazepines are long acting compared to flumazenil, repeated doses may be necessary.

Almitrine does not produce central respiratory stimulation but it does improve ventilation-perfusion matching by augmenting hypoxic pulmonary vasoconstriction. Effects continue for several hours after injection.

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