Urinary metabolites of doxapram in premature neonates

1. Urine samples from 20 premature neonates who received doxapram by i.v. infusion were analysed for drug metabolites by g.l.c-mass spectrometry.

2. In addition to doxapram, all urines contained at least one metabolite, but the known metabolite, 3-ketodoxapram, was detected in only 50% of the samples, and in some instances only in trace amounts.

3. Significant inter-individual differences in the metabolic pathways of doxapram were observed.

4. A total of six metabolites of doxapram were isolated three of which have not been observed previously in human or in dog.

5. Appropriate structures for the new metabolites have been deduced from their mass spectral fragmentation pathways, and are 1-ethyl-4-[2-(N-formyl-N-(-2-hydroxy-ethyl)amino)ethyl]-3,3-diphenyl-2-pyrrolidinone (VII), 1-ehtyl-4-[2-(4-morpholin-2-only)ethyl]-3,3-diphenyl-2-pyrrolidinone (IX) and 4-ethyl-1-ethyl-3,3-diphenyl-2-pyrrolidinone (X).