Respiratory stimulants are a group of medications that can be administered to clients with asthma, chronic obstructive pulmonary disease or COPD for short, or respiratory depression; as well as to treat apnea of prematurity.
Respiratory stimulants include doxapram, which is administered intravenously, as well as certain phosphodiesterase enzyme inhibitors, also known as methylxanthines, such as caffeine, theophylline, and aminophylline, which are most often taken orally, but they can also be given intravenously.
Once administered, these medications primarily work on the brainstem and medulla by stimulating the respiratory center, and thus act as respiratory stimulants.
In addition, methylxanthines can also act on the lungs by inhibiting the phosphodiesterase enzyme, and ultimately cause bronchodilation.
Side effects commonly caused by respiratory stimulants include muscle tremors, agitation, anxiety, irritability, and insomnia. Clients might also experience gastrointestinal disturbances like nausea, vomiting, and diarrhea.
These drugs may also cause hypertension, heart palpitations, tachycardia, and ECG abnormalities.
In addition, theophylline has a very narrow therapeutic window, meaning it's very easy to overdose, and can cause arrhythmias or seizures.
Finally, administering high doses of caffeine to premature infants can lead to intracranial hemorrhage.
As far as contraindications go, respiratory stimulants are contraindicated in clients with severe arteriosclerosis, symptomatic cardiovascular disease, and moderate to severe hypertension.
