Doxapram may be used in neonates for which indication?

• A. Apnea of prematurity that is refractory to methylxanthines
• B. Improve pulmonary function in cystic fibrosis patients
• C. Treatment of persistent hyperinsulinemic neonatal hypoglycemia
• D. Neonatal sepsis prophylaxis

Answer: (A)

Doxapram is a central and peripheral respiratory stimulant used in neonates to increase ventilatory drive when apnea of prematurity persists despite methylxanthine therapy. In the immature neonatal brain, breathing control is underdeveloped, and while caffeine or theophylline can help, some infants remain apneic; doxapram is employed as a short-term rescue to刺激 respiration and reduce apnea events under careful NICU monitoring. It is not used to improve lung function in cystic fibrosis, nor to treat persistent hyperinsulinemic neonatal hypoglycemia, nor as neonatal sepsis prophylaxis, since it does not address those conditions. Thus, the best indication is apnea of prematurity refractory to methylxanthines.