Drugs that can Stimulate Respiration
Almitrine is a respiratory stimulant that enhances peripheral chemoreceptor sensitivity. Although it can potentially improve nighttime oxygenation, this effect is generally mild and inconsistent.
Acetazolamide administration induces metabolic acidosis from bicarbonate diuresis; this, in turn, can stimulate respiration. Although it is beneficial for the treatment of high altitude–related periodic breathing, its usefulness for patients with obstructive sleep apnea is limited, inconsistent, and unpredictable.
Certain antidepressants, such as protriptyline, a tricyclic antidepressant, and fluoxetine, a selective serotonin reuptake inhibitor, can decrease the frequency and duration of apnea-hypopneas both by increasing upper airway muscle tone and decreasing percentage of REM sleep, during which sleep-disordered breathing tends to be worse as compared with that during NREM sleep. Their clinical use, however, in treating patients with sleep apnea is not established.
Nicotine is a respiratory stimulant. Not with standing its effect of enhancing upper airway muscle activity, it has no role in the therapy of obstructive sleep apnea.
Progesterone can increase hypoxic and hypercapnic respiratory responses and minute ventilation; it can improve ventilation in patients with obesity-hypoventilation syndrome and decrease apnea-hypopneas in postmenopausal women.
Theophylline can reverse the bronchospasm of nocturnal asthma, increase sleep-related oxygen saturation in patients with chronic obstructive pulmonary disease, and improve Cheyne-Stokes crescendo-decrescendo periodic breathing.
Source : Respiratory Disorders and Sleep, An Issue of Sleep Medicine Clinics (The Clinics: Internal Medicine)
