DESCRIPTION
Bromhexine – Bromhexine is an expectorant/mucolytic agent. Bromhexine is not available in the United States. It is marketed under the trade name Bisolvon® in Germany, England, Belgium, France, Italy, Netherlands, Norway, Sweden, Australia, and South Africa. Guaifenesin -An expectorant that also has .Ammonium chloride, an inorganic compound with the formula NH4Cl, is a white crystalline salt, highly soluble in water. Solutions of ammonium chloride are mildly acidic. Sal ammoniac is a name of the natural, mineralogical form of ammonium chloride. The mineral is commonly formed on burning coal dumps, due to condensation of coal-derived gases. It is also found around some types of volcanic vents. It is used as a flavouring agent in some types of liquorice. It is the product from the reaction of hydrochloric acid and ammonia.
CATEGORIES
Bromhexine – Cough & Cold Preparations,Guaifenesin – Expectorants ,Terbutaline – Sympathomimetics,Adrenergic beta-2 Receptor Agonists,Bronchodilator Agents,Tocolytic Agents.It is used as a flavouring agent in some types of liquorice. It is the product from the reaction of hydrochloric acid and ammonia.Ammonium chloride is used in a ~5% aqueous solution to work on oil wells with clay swelling problems. It is also used as electrolyte in zinc–carbon batteries. Other uses include in hair shampoo, in the glue that bonds plywood, and in cleaning products. In hair shampoo, it is used as a thickening agent in ammonium-based surfactant systems, such as ammonium lauryl sulfate. Ammonium chloride is used in the textile and leather industry in dyeing, tanning, textile printing and to luster cotton.
CHEMICAL FORMULA
Bromhexine – C14H20Br2N2,Guaifenesin -C10H14O4, Ammonium chloride -H4ClN
COMPOSITION
Guaifenesin (Guaiphenesin/Gyceral Guaiacolate)50 mg+Ammonium chloride-100 mg+Bromhexine Hydrochloride-4 mg
INDICATION
Guaifenesin -Used to assist the expectoration of phlegm from the airways in acute respiratory tract infections.Also used acute IV and sub-Q therapy in selected women to inhibit uterine contractions in preterm labor (tocolysis) and prolong gestation when beneficial.
PHARMACODYNAMICS
Guaifenesin -Guaifenesin is an expectorant which increases the output of phlegm (sputum) and bronchial secretions by reducing adhesiveness and surface tension. The increased flow of less viscous secretions promotes ciliary action and changes a dry, unproductive cough to one that is more productive and less frequent. By reducing the viscosity and adhesiveness of secretions, guaifenesin increases the efficacy of the mucociliary
MECHANISM
in removing accumulated secretions from the upper and lower airway. Terbutaline -Terbutaline is a relatively selective beta2-adrenergic bronchodilator that has little or no effect on alpha-adrenergic receptors. The drug has exerts a preferential effect on beta2-adrenergic receptors but stimulates beta-adrenergic receptors less selectively than relatively selective beta2-agonists. Terbutaline appears to have a greater stimulating effect on beta-receptors of the bronchial, vascular, and uterine smooth muscles (beta2 receptors) than on the beta-receptors of the heart (beta1 receptors). This drug relaxes smooth muscle and inhibits uterine contractions, but may also cause some cardiostimulatory effects and CNS stimulation.
MECHANISM
Guaifenesin -Guaifenesin may act as an irritant to gastric vagal receptors, and recruit efferent parasympathetic reflexes that cause glandular exocytosis of a less viscous mucus mixture. Cough may be provoked. This combination may flush tenacious, congealed mucopurulent material from obstructed small airways .
ABSORPTION
Guaifenesin -Rapidly absorbed from the GI tract.
METABOLISM
Guaifenesin -Rapidly hydrolyzed (60% within seven hours) and then excreted in the urine, with beta-(2-methoxyphenoxy)-lactic acid as its major urinary metabolite.
HALF LIFE
Guaifenesin -1 hour
TOXICITY
Guaifenesin -LD50 1510 mg/kg (rat, oral)
FOOD INTERACTIONS
avoid alcohol
SIDE EFFECTS
Bromhexine – Rhinorrhoea, lacrimation, gastric irritation and hypersensitivity.Guaifenesin – Feeling dizzy. Rise slowly over a few minutes when sitting or lying down. Be careful climbing. Headache. Upset stomach or throwing up. Many small meals, good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help. Terbutaline – Nervous and excitable. Headache. Upset stomach or throwing up. Many small meals, good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help. Dry mouth. Good mouth care, sucking hard, sugar-free candy, or chewing sugar-free gum may help. See a dentist often. Not able to sleep. – Shot: – Low blood pressure. Flushing. Wearing layers of clothes or summer clothes and staying in cool places may help. Low potassium levels. Signs include feeling tired, weak, numbness, or tingling; muscle cramps; hard stools (constipation); throwing up; or a fast heartbeat. High blood sugar may cause diabetes while on this drug. This most often goes back to normal when this drug is stopped.