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- Pharmacology For Salbutamol + Bromhexine + Phenylephrine
Salbutamol + Bromhexine + Phenylephrine Pharmacology
Salbutamol + Bromhexine + Phenylephrine
About Salbutamol + Bromhexine + PhenylephrineN/AMechanism of Action of Salbutamol + Bromhexine + PhenylephrineN/APharmacokinets of Salbutamol + Bromhexine + PhenylephrineN/AOnset of Action for Salbutamol + Bromhexine + PhenylephrineN/ADuration of Action for Salbutamol + Bromhexine + PhenylephrineN/AHalf Life of Salbutamol + Bromhexine + PhenylephrineN/ASide Effects of Salbutamol + Bromhexine + PhenylephrineN/AContra-indications of Salbutamol + Bromhexine + PhenylephrineN/ASpecial Precautions while taking Salbutamol + Bromhexine + PhenylephrineN/APregnancy Related InformationN/AOld Age Related InformationN/ABreast Feeding Related InformationN/AChildren Related InformationN/AIndications for Salbutamol + Bromhexine + PhenylephrineN/AInteractions for Salbutamol + Bromhexine + PhenylephrineN/ATypical Dosage for Salbutamol + Bromhexine + PhenylephrineN/ASchedule of Salbutamol + Bromhexine + PhenylephrineN/AStorage Requirements for Salbutamol + Bromhexine + PhenylephrineN/AEffects of Missed Dosage of Salbutamol + Bromhexine + PhenylephrineN/AEffects of Overdose of Salbutamol + Bromhexine + PhenylephrineN/ASalbutamol
About SalbutamolBeta2-Adrenergic Agonist, Phenethylamine derivative, Bronchodilator(Antiasthma), uterine relaxant.Mechanism of Action of SalbutamolSalbutamol is a short acting ?2 receptor agonist. It selectively stimulates ?2 receptors present in airway, Uterus, and Vascular Smooth muscles. It 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.
?2 receptor agonists also suppress the release of Leukotrienes and histamine from the mast cells in the lung tissue and enhance mucociliary function and decrease micro vascular permeability and also inhibits Phospholipase A2 which produces inhibition of prostaglandins production. Thus Salbutamol can inhibit the broncho-constriction produced by inflammatory mediators. Salbutamol is effective in the management of preterm labour.
Pharmacokinets of SalbutamolAbsorption: It is well absorbed after oral administration.
Distribution: Salbutamol does not cross the blood brain barrier.
Metabolism: It is metabolised to inactive metabolites in the liver
Excretion: Salbutamol is excreted primarily in the urine and small amount in the faeces.
Onset of Action for Salbutamol15 - 30 minutesDuration of Action for Salbutamol6 - 12 hoursHalf Life of Salbutamol4 hoursSide Effects of Salbutamol1. 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. Hypokalaemia (high dose)
Contra-indications of Salbutamol1.Hypersensitivity to Salbutamol and other sympathomimetic amines.Special Precautions while taking Salbutamol1. Myocardial insufficiency
2. Arrhythmia
3. Hypertension
4. Hyperthyroidism
5. Epilepsy
6. Diabetes
Pregnancy Related InformationUse with caution.Old Age Related InformationUse with caution.Breast Feeding Related InformationUse with caution.Children Related InformationUse with caution
Below 6 years: contraindicatedIndications for Salbutamol1. Obstructive airway diseases
2. Acute Bronchospasm
3. Status asthmaticus
4. Premature labour
Interactions for SalbutamolBeclomethasone, Theophylline: Enhances respiratory function.
Beta-blockers: Inhibit bronchodilator effect.
Diuretics and Xanthines: Increased risk of hypokalemia.
Digitalis: Increased risk of digitalis toxicity when salbutamol is given in hilgh doses due to hypokalaemia.Typical Dosage for SalbutamolAdult:
Oral:
Immediate release tablet: 2 - 4 mg every 6 - 8 hours daily, maximum dose 32mg / day
Sustained release tablets: 8 mg / day in 2 divided doses and if sufficient response does not obtained then dose can be gradually increased to 16mg / day in 2 divided doses
Children: 6 - 14 years
Syrup: 6 - 8mg / day in 3 - 4 divided doses and if needed dose can be increased maximum up to 24mg / day
Uterine Relaxant: (I.V) 4 to 32 mcg/minutes
Schedule of SalbutamolHStorage Requirements for SalbutamolStore at 15 - 30 degree C. Protect from heat and light. Keep out of the reach of childrenEffects of Missed Dosage of SalbutamolTake 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 SalbutamolGive 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 BromhexineMucolytic (secretolytic)Mechanism of Action of BromhexineBromhexine 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 BromhexineAbsorption: 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 BromhexineN/ADuration of Action for BromhexineN/AHalf Life of Bromhexine12hours.Side Effects of Bromhexine1 Rhinorrhoea
2 Lacrimations
3.Allergic reactions
4.Gastric irritation.Contra-indications of BromhexineHypersensitivity to the drug.Special Precautions while taking Bromhexine1. Hepatic impairment
2. Renal impairment
3. Gastric and duodenal ulcer
4. Convulsive disorders
Pregnancy Related InformationContraindicatedOld Age Related InformationUse with cautionBreast Feeding Related InformationContraindicatedChildren Related InformationUse with cautionIndications for Bromhexine1. 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 BromhexineN/ATypical Dosage for BromhexineOral: 8mg thrice daily.
Children (5 to 10 years): 4mg thrice daily
Children (1 to 5 years): 4mg twice daily.
Schedule of BromhexineHStorage Requirements for BromhexineStore in a cool dry place and protect from light. Keep out of reach of children.Effects of Missed Dosage of BromhexineTake 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 BromhexineProvide symptomatic treatment and supportive measures.Phenylephrine
About PhenylephrineAn a1-adrenergic receptor agonist, Phenethylamine derivative, Decongestant, Antiglaucoma, Mydriatic.Mechanism of Action of PhenylephrineThe 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 PhenylephrineAbsorption: Variable depending up on the route of administration. Metabolism: Metabolized in the liver and intestine.Onset of Action for PhenylephrineNasal: Rapid
Ophthalmic: Rapid
I.V.: Rapid
I.M.: Within 15 minutes
Duration of Action for PhenylephrineNasal: ? to 4 hours
Ophthalmic: 3 to 7 hours
I.V.: 15 to 20 minutes
I.M.: ? to 2 hours.
Half Life of PhenylephrineN/ASide Effects of Phenylephrine1.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 Phenylephrine1.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 Phenylephrine1.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 InformationUse with cautionOld Age Related InformationUse with cautionBreast Feeding Related InformationUse with cautionChildren Related InformationUse with caution
Below age 6:contraindicatedIndications for Phenylephrine1.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 PhenylephrineMay interact with systemically administered MAOIs.Typical Dosage for PhenylephrineI.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 PhenylephrineN/AStorage Requirements for PhenylephrineStore 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 PhenylephrineTake 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 PhenylephrineDiscontinue 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.
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