Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin Pharmacology

Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin

About Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Mechanism of Action of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Pharmacokinets of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Onset of Action for Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Duration of Action for Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Half Life of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Side Effects of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Contra-indications of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Special Precautions while taking Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + 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 Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Interactions for Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Typical Dosage for Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Schedule of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Storage Requirements for Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Effects of Missed Dosage of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Effects of Overdose of Paracetamol + Chlorpheniramine maleate + Phenylephrine + Bromhexine + Guaiphenesin
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Paracetamol

About Paracetamol
Acetanilide derivative, Non narcotic Analgesic,Antipyretic.
Mechanism of Action of Paracetamol
Paracetamol has analgesic and antipyretic action.
It is more active on cyclo-oxygenase enzyme in brain. Peripherally it is a poor inhibitor of prostaglandin synthesis.
Analgesic action: Paracetamol raises the pain threshold and produces analgesic effect.
Antipyretic action: Paracetamol lowers fever by direct action on the thermoregulatory centre in the Hypothalamus and block the effects of endogenous pyrogen.
Pharmacokinets of Paracetamol
Absorption: Paracetamol is rapidly and completely absorbed after oral administration.
Distribution: It is distributed mostly in the body in unbound form.
Metabolism: It is extensively metabolised in the liver.
Excretion: Excreted in the urine.
Onset of Action for Paracetamol
30 - 60 minutes
Duration of Action for Paracetamol
6 hours
Half Life of Paracetamol
1-4 hours
Side Effects of Paracetamol
1. Nausea
2. Abdominal distress
3. Allergic reactions
4. Rash
Contra-indications of Paracetamol
1. Hypersensitivity to Paracetamol
Special Precautions while taking Paracetamol
1. Hepatic impairment
2. Renal impairment
3. Hypertension
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
NEONATES : Contraindicated
Indications for Paracetamol
1. To relieve pain and fever
2. Acute gout
3. Migraine
Interactions for Paracetamol
Cholestyramine: Reduces absorption of paracetamol.
Charcoal: Activated, administered immediately reduces absorption of paracetamol.
Domperidone and metochlopramide: Enhance absorption of paracetamol.
Alcohol: Chronic excessive ingestion of alcohol potentiates hepatotoxicity of paracetamol.
Zidovudine: Effects zidovudine may be decreased.
Typical Dosage for Paracetamol
Adult:
500 - 1000 mg in 3 times daily
Maximum dose: 4 g / day
For migraine: 500 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
60 mg / kg body weight /day in 4 divided doses.
Schedule of Paracetamol
H
Storage Requirements for Paracetamol
Store at 15-30 degree C in a tightly closed container. Protect from heat and moisture. Keep out of the reach of children.
Effects of Missed Dosage of Paracetamol
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 Paracetamol
Give supportive measures and symptomatic treatment. Drug can be removed from the body by gastric lavage or by inducing emesis. Absorption of the drug can be reduced by administration of activated charcoal. N-acetylcysteine is the specific antidote for Paracetamol poisoning. Dose: 150 mg /kg body weight as IV infusion over 15 minutes followed by same dose over 20 hours.
Maintenance dose: 75 mg / kg orally every 4 - 6 hours for 2 - 3 days. Haemodialysis can be done in emergency conditions.

Chlorpheniramine Maleate

About Chlorpheniramine Maleate
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Mechanism of Action of Chlorpheniramine Maleate
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Pharmacokinets of Chlorpheniramine Maleate
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Onset of Action for Chlorpheniramine Maleate
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Duration of Action for Chlorpheniramine Maleate
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Half Life of Chlorpheniramine Maleate
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Side Effects of Chlorpheniramine Maleate
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Contra-indications of Chlorpheniramine Maleate
First Generation alkylamine H1 Antagonist, Antihistamine.
Special Precautions while taking Chlorpheniramine Maleate
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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 Chlorpheniramine Maleate
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Interactions for Chlorpheniramine Maleate
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Typical Dosage for Chlorpheniramine Maleate
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Schedule of Chlorpheniramine Maleate
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Storage Requirements for Chlorpheniramine Maleate
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Effects of Missed Dosage of Chlorpheniramine Maleate
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Effects of Overdose of Chlorpheniramine Maleate
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Phenylephrine

About Phenylephrine
An a1-adrenergic receptor agonist, Phenethylamine derivative, Decongestant, Antiglaucoma, Mydriatic.
Mechanism of Action of Phenylephrine
The drug exerts it`s pharmacological action by acting as a selective alpha-1 adrenergic agonist. It causes vasoconstriction and increases total peripheral resistance and raises blood pressure. It reduces intraocular tension by constricting ciliary body blood vessels and produce mydriasis (without cycloplegia). It exerts nasal decongestant action; by vasoconstrictory action on arterioles of nasal mucosa. It prolongs and localizes the action of anaesthetics due to it`s vasoconstrictory action on skin, mucous membrane, and viscera and thus slows the rate of absorption of local anaesthetics.
Pharmacokinets of Phenylephrine
Absorption: Variable depending up on the route of administration. Metabolism: Metabolized in the liver and intestine.
Onset of Action for Phenylephrine
Nasal: Rapid
Ophthalmic: Rapid
I.V.: Rapid
I.M.: Within 15 minutes
Duration of Action for Phenylephrine
Nasal: ? to 4 hours
Ophthalmic: 3 to 7 hours
I.V.: 15 to 20 minutes
I.M.: ? to 2 hours.


Half Life of Phenylephrine
N/A
Side Effects of Phenylephrine
1.Bradycardia
2.Arrhythmias
3.Hypertension
4.Tachycardia
5.Palpitations
6.Premature ventricular contractions
7.Pallor
8.Headache
9.Dizziness
10.Nervousness
11.Brow ache(with ophthalmic form)
12.Burning or stinging in eye
13.Blurred vision
14.Elevated intraocular pressure
15.Nausea
16.Episodes of asthma
17.Tachyphylaxis
18.Anaphylaxis


Contra-indications of Phenylephrine
1.Hypersensitivity to the drug
2.Hyperthyroidism
3.Ventricular tachycardia and severe hypertension (Injected form)
4.Angle closure glaucoma and in those who wear soft contact lenses(ophthalmic form)
Special Precautions while taking Phenylephrine
1.Coronary diseases
2.Advanced arteriosclerosis
3.Bradycardia
4.Partial heart block
5.Myocardial diseases
6.Atherosclerosis
7.Hypertension
8.Nasal and ophthalmic form use cautiously in type-1 diabetes mellitus

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
Below age 6:contraindicated
Indications for Phenylephrine
1.Hypotension
2.Paroxysmal supra ventricular tachycardia
3.Maintain blood pressure during spinal and inhalation anaesthesia
4.Prolongation of spinal anaesthesia
5.Shock
6.Mydriasis(without cycloplegia)
7.Nasal congestion.
8.Cataract

Interactions for Phenylephrine
May interact with systemically administered MAOIs.
Typical Dosage for Phenylephrine
I.M. or S.C.: 2 to 5mg. Then if required; give doses up to 10mg.
Slow I.V. injection: 0.1 to 0.5mg. Then if required; repeat after 15 minutes.
I.V. infusion: Starts with 0.18mg/minute. Then adjust the dosage up to 0.03 to 0.06mg/minute based on patient`s response.
Nasal congestion: Apply 2 to 3 drops or 1 to 2 sprays of 0.25% to 1% solution instilled in each nostril.
Mydriasis (without cycloplegia): Instill 1 to 2drops 2.5% or 10% solution in eye. Repeated if required.
Prolongation of spinal anaesthesia: 2 to 5mg added to anaesthetic solution.
Schedule of Phenylephrine
N/A
Storage Requirements for Phenylephrine
Store at controlled room temperature at range of 15 to 30 degree C. in a well closed container. Protect from light.
Effects of Missed Dosage of Phenylephrine
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 Phenylephrine
Discontinue the drug and give supportive and symptomatic treatment. Closely monitor vital signs. Use atropine sulfate to block reflex Bradycardia. Treat excessive hypertension with phentolamine. Treat cardiac arrhythmia with propranolol. Treat excessive mydriatic effect with levodopa.

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.

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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