Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin Pharmacology

Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin

About Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Mechanism of Action of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Pharmacokinets of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Onset of Action for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Duration of Action for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Half Life of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Side Effects of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Contra-indications of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Special Precautions while taking Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Interactions for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Typical Dosage for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Schedule of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Storage Requirements for Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Effects of Missed Dosage of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Effects of Overdose of Terbutaline + Bromhexine + Ammonium chloride + Guaiphenesin
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Terbutaline

About Terbutaline
A ?2-adrenergic agonist,a fast-acting bronchodilator, Tocolytic,Anti asthma.
Mechanism of Action of Terbutaline
Terbutaline is a ?2 receptor agonist. Terbutaline directly relaxes the airway smooth muscles and produces bronchodilation. Stimulation of ?2 receptors activates Gs adenylyl-cyclase -cyclic AMP path way and produces reduction in smooth muscle tone. ?2 receptor agonists also increases the conductance of large Ca2+sensitive K+ channels in airway smooth muscles and leads to membrane hyperpolarisation and relaxation of smooth muscles.
Tocolytic action: In premature labour Terbutaline relaxes uterine smooth muscles and inhibits uterine contractions.

Pharmacokinets of Terbutaline
Absorption: It is partially absorbed (about 33- 50%) after oral administration
Distribution: It is widely distributed in the body.
Metabolism: It is partially metabolised in the liver to inactive compounds.
Excretion: Drug and its metabolites are excreted mainly in urine.

Onset of Action for Terbutaline
30 minutes (oral), 15 minutes (subcutaneous), 5-30 minutes (inhalation)
Duration of Action for Terbutaline
4- 8 hours (oral), 1.5-4 hours (subcutaneous), 3- 6 hours (inhalation).
Half Life of Terbutaline
N/A
Side Effects of Terbutaline
1. Drowsiness
2. Headache
3. Dizziness
4. Nervousness
5. Tremor
6. Weakness
7. Palpitations
8. Tachycardia
9. Arrhythmia
10. Vomiting
11. Nausea
12. Heartburn
13. Diaphoresis
14. Dry and irritated nose (inhalation)
15. Hypokalaemia (high dose)
Contra-indications of Terbutaline
1. Hypersensitivity to Terbutaline and other sympathomimetic amines.
Special Precautions while taking Terbutaline
1. Myocardial insufficiency
2. Arrhythmia
3. Hypertension
4. Hyperthyroidism
5. Epilepsy
6. Diabetes
Pregnancy Related Information
Use with caution.
Old Age Related Information
Use with caution.
Breast Feeding Related Information
Use with caution.
Children Related Information
Use with caution
CHILDREN Below 12 years : contraindicated
NEONATES: contraindicated
Indications for Terbutaline
1. Obstructive airway diseases
2. Acute Bronchospasm
3. Status asthmaticus
4. Premature labour
Interactions for Terbutaline
Other Sympathomimetic bronchodilators or epinephrine: Combined effect on the cardiovascular system may be deleterious to the patient.
MAOIs and TCAs: Effect of terbutaline on vascular system may be potentiated.
Beta-adrenergic blocking agents: Block the pulmonary effect of terbutaline and may produce severe asthmatic attacks in asthmatic patients.
Beclomethasone, Theophylline: Synergy when used with these agents.
Food: Reduces bioavailability of terbutaline.
Typical Dosage for Terbutaline
Adult:
Oral: Initial dose: 7.5 mg / day in 3 divided doses, if needed dose can be increased to 15mg /day in 3 divided doses.
Subcutaneous /Intramuscular/slow IV infusion: 250 - 500mcg 3 - 4 times daily
Aerosol inhalation: 250 - 500mcg every 6 - 8 hours
Nebulised solution inhalation: 5 - 10 mg every 6 - 12 hours.
Children:
Oral: Initial dose: 2.5 mg in 2-3 times daily
Subcutaneous /Intramuscular/slow IV infusion: 10mcg /kg body weight dose can be increased to 300 mcg / day
Aerosol inhalation: 250 - 500mcg every 6 - 8 hours
Nebulised solution inhalation: 2 - 5 mg every 6 - 12 hours.
Premature labor (IV): Initial dose: 10mcg/minute and dose can be repeated until effective therapeutic response is obtained. Maximum dose: 80mcg/minute. Maintenance dose (IV dosage): Minimum effective dose for 4 hours.

Schedule of Terbutaline
H
Storage Requirements for Terbutaline
Store at 15 - 30 degree C. Protect from heat and light.
Effects of Missed Dosage of Terbutaline
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Terbutaline
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of drug can be reduced by administration of activated charcoal.

Bromhexine

About Bromhexine
Mucolytic (secretolytic)
Mechanism of Action of Bromhexine
Bromhexine hydrochloride acts as a mucokinetic and mucolytic agent. It decreases mucus viscosity by altering its structure. It depolymerises mucopolysaccharides directly as well as by liberating lysosomal enzymes and network of fibres in tenacious sputum is broken. It induces thin copious bronchial secretion.
Pharmacokinets of Bromhexine
Absorption: Bromhexine hydrochloride is rapidly absorbed from the gastrointestinal tract and bioavailability is about 20%. Distribution: It is widely distributed to body tissues in a highly protein bound form; Bromhexine crosses the blood brain barrier and small amounts cross the placenta, Metabolism: It undergoes extensive first-pass metabolism in the liver. Excretion: It is excreted primarily in the urine mainly as metabolites.
Onset of Action for Bromhexine
N/A
Duration of Action for Bromhexine
N/A
Half Life of Bromhexine
12hours.
Side Effects of Bromhexine
1 Rhinorrhoea
2 Lacrimations
3.Allergic reactions
4.Gastric irritation.
Contra-indications of Bromhexine
Hypersensitivity to the drug.
Special Precautions while taking Bromhexine
1. Hepatic impairment
2. Renal impairment
3. Gastric and duodenal ulcer
4. Convulsive disorders
Pregnancy Related Information
Contraindicated
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
Use with caution
Indications for Bromhexine
1. As Expectorant and mucolytic
2. Conditions associated with production of viscid mucous
3. Bronchitis
4. Pharyngitis
5. Laryngitis
6. Rhinitis
7. Sinusitis
8. Asthmatic bronchitis
9. Mucous bronchiectasis
10.Chronic Pneumonia.
Interactions for Bromhexine
N/A
Typical Dosage for Bromhexine
Oral: 8mg thrice daily.
Children (5 to 10 years): 4mg thrice daily
Children (1 to 5 years): 4mg twice daily.
Schedule of Bromhexine
H
Storage Requirements for Bromhexine
Store in a cool dry place and protect from light. Keep out of reach of children.
Effects of Missed Dosage of Bromhexine
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Bromhexine
Provide symptomatic treatment and supportive measures.

Ammonium chloride

About Ammonium chloride
Ammonium compound, Acidifier,Expectorant.
Mechanism of Action of Ammonium chloride
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Pharmacokinets of Ammonium chloride
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Onset of Action for Ammonium chloride
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Duration of Action for Ammonium chloride
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Half Life of Ammonium chloride
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Side Effects of Ammonium chloride
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Contra-indications of Ammonium chloride
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Special Precautions while taking Ammonium chloride
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Pregnancy Related Information
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Old Age Related Information
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Breast Feeding Related Information
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Children Related Information
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Indications for Ammonium chloride
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Interactions for Ammonium chloride
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Typical Dosage for Ammonium chloride
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Schedule of Ammonium chloride
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Storage Requirements for Ammonium chloride
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Effects of Missed Dosage of Ammonium chloride
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Effects of Overdose of Ammonium chloride
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Guaiphenesin

About Guaiphenesin
Propanediol derivative, Expectorant.
Mechanism of Action of Guaiphenesin
Guaiphenesin is an expectorant which after absorption from the gastrointestinal tract secreted by tracheobronchial glands and directly increase bronchial secretion and mucosal ciliary action. It increases respiratory tract fluid by reducing adhesiveness and surface tension, reducing viscosity of the secretions and there by facilitating their removal and clears chest congestion.
Action in local vaginal preparations: Guaiphenesin helps to thin the thick or sticky cervical mucus.

Pharmacokinets of Guaiphenesin
Absorption: Well absorbed orally.Distribution: It is secreted by the tracheobronchial glands.
Metabolism: It is metabolized primarily to Beta-2-methoxyphenoxy-lactic acid. Excretion: It is excreted in the urine.
Onset of Action for Guaiphenesin
N/A
Duration of Action for Guaiphenesin
N/A
Half Life of Guaiphenesin
60 minutes
Side Effects of Guaiphenesin
1. Headache
2. Dizziness
3. Nausea
4. Vomiting
5. Rash
6. Diarrhoea
7. Drowsiness
8. Stomach pain
Contra-indications of Guaiphenesin
1. Hypersensitivity to the drug
2. Chronic or persistent cough associated with chronic lower respiratory tract diseases
3. Asthma
4. Bronchitis
5. Chronic obstructive pulmonary disease (COPD)
6. Emphysema
Special Precautions while taking Guaiphenesin
1. Porphyria
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Contraindicated
Children Related Information
May be used
Indications for Guaiphenesin
1. Expectorant
2. Thick or sticky cervical mucus
Interactions for Guaiphenesin
N/A
Typical Dosage for Guaiphenesin
Oral :
Adults and children over 12 years: 100 to 400mg up to 6 times daily as required.Maximum dose: 2.4g/day
Children (age 6 to 11): 100 to 200mg up to 6 times daily as required.Maximum dose: 1.2g/day
Children (age 2 to 5): 50 to 100mg up to 6 times daily as required.Maximum dose: 600mg/day
Extended release:
Adults and children over 12 years: 600 to 1200mg twice daily. Not to exceed 2.4g in 24 hours
Children (age 6 to 12): 600mg twice daily. Not to exceed 1.2g in 24 hours
Children (age 2 to 6): 300mg twice daily. Not to exceed 600mg in 24 hours
Thick or sticky cervical mucus: 200mg 2 to 3 times daily from 4 days prior to ovulation and continue through ovulation day.
Schedule of Guaiphenesin
N/A
Storage Requirements for Guaiphenesin
Store at a temperature below 30 degree C. Keep out of reach of children.
Effects of Missed Dosage of Guaiphenesin
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Guaiphenesin
Provide symptomatic treatment and supportive measures.

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