Treatment of Ethanol Poisoning and Associated Hypoventilation with Doxapram

Abstract Ethanol poisoning often results in profound coma with hypoventilation lasting several hours. Doxapram, a central nervous system respiratory stimulant, was utilized to safely counter the effects of ethanol, avoid need for intubation, and prevent unnecessary admission to the intensive care un...

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Bibliographic Details
Published in:The American journal of emergency medicine 2016-11, Vol.34 (11), p.2253.e1-2253.e2
Main Authors: Richards, John R., MD, Laurin, Erik G., MD, Bretz, Stephen W., MD, Traylor, Brittany R., PharmD, BCPS, Panacek, Edward A., MD
Format: Article
Language:English
Subjects:
Alcohol
Anesthesia
Blood pressure
Calcium channels
Central Nervous System Stimulants - therapeutic use
Consciousness
Doxapram - therapeutic use
Drug abuse
Drug dosages
Emergency
Emergency medical care
Emergency Service, Hospital
Ethanol
Ethanol - poisoning
Humans
Hypoventilation - chemically induced
Hypoventilation - drug therapy
Intensive care
Intubation
Male
Middle Aged
Nervous system
Patients
Poisoning
Professional relationships
Respiratory System Agents - therapeutic use
Substance abuse treatment
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Summary:Abstract Ethanol poisoning often results in profound coma with hypoventilation lasting several hours. Doxapram, a central nervous system respiratory stimulant, was utilized to safely counter the effects of ethanol, avoid need for intubation, and prevent unnecessary admission to the intensive care unit. We report a case of ethanol poisoning in a 48-year-old male who presented to the emergency department (ED) with altered mental status, hypoventilation, and hypoxemia. Intravenous doxapram was administered, and within seconds his ventilatory status returned to normal. His altered mental status also improved to the point at which he became alert and conversant. Further dosing of doxapram was not required. Doxapram, an old and rarely utilized drug in the ED, is an analeptic that is advantageous in the treatment of hypoventilation from sedative overdose for which there is no specific antidote. For appropriate cases of ethanol poisoning with hypoventilation, emergency physicians should consider doxapram before proceeding to intubation.
ISSN:0735-6757
1532-8171
DOI:10.1016/j.ajem.2016.05.004