Aspirin + Noscapine + Chlorpheniramine Maleate + Pseudoephedrine Pharmacology
Aspirin + Noscapine + Chlorpheniramine Maleate + Pseudoephedrine
2.Cough
3.Rhinitis
Aspirin
Peripheral action: It acts by inhibition of Prostaglandin (PGs) synthesis by blocking the activity of the precursor enzyme cyclo-oxygenase.
Anti-inflammatory action: It acts by inhibiting Prostaglandin (PGs) synthesis and their release at the site of injury. Prostaglandins cause tenderness and amplify the action of other algesics. Aspirin inhibits cyclo-oxygenase enzyme and antagonizes prostaglandin actions. It also inhibits other inflammatory mediators.
Antipyretic action: Aspirin lowers fever by affecting thermoregulation in the CNS and by inhibiting the action of prostaglandins peripherally. Aspirin inhibits the production of prostaglandin E1 which is the powerful pyretic agent.
Anticoagulant action: Aspirin inhibits the synthesis of Thromboxane A2 and Prostacyclin (PGI2). This leads to inhibition of platelet aggregation.
2.Vomiting,
3.Diarrhoea,
4.Gastrointestinal bleeding,
5.Abdominal distress,
6.Dyspepsia,
7.Dizziness,
8.Blurred vision,
9.Tinnitus,
10.Rash,
11.Pruritis
12.Ototoxicity
2.Peptic ulcer,
3.Bleeding disorders- Haemophilia, von Willebrand`s disease
4.Chicken pox and flu like syndrome in children
2.Renal impairment
3.Cardiovascular diseases- hypertension
4.Gastrointestinal diseases
5.Hypoprothrombinemia
6.Pre existing asthma
7.Patient on anticoagulant therapy
8.Diabetes
3rd trimester: Contraindicated
NEONATES: contraindicated
2.Ankylosing spondylitis,
3.Acute gout,
4.Joint disorders e.g. inflammatory disease in joints, crystal deposition in the joints,
5.Osteoarthritis,
6.For the relief of fever, pain and inflammation in dental, minor surgery and orthopedic
7.Dysmenorrhoea,
8.Rheumatic fever
9. Juvenile arthritis
10.Migraine
Activated charcoal: Decreases absorption of aspirin.
Antacids Urinary alkalizers and Cortiosteroids: Decrease efficacy of aspirin.
Drugs affected by aspirin:
Alcohol: Risk of G.I. ulceration increases; may also prolong bleeding time.
ACE inhibitors: Antihypertensive action decreased.
Oral Anticoagulants : May potentiate effect.
Methotrexate: Effect potentiated.
Tetracycline: Efficacy decreased.
Tricyclic Antidepressants - Effect potentiated.
Nitroglycerin: May result in unexpected hypotension.
Beta-adrenergic Blockers - Antihypertensive effect blunted.
NSAIDs: May decrease serum concentration.
Sulfonylureas and Exogenous Insulin: In high doses may potentiate these drugs.
Valproic Acid: Potentiates effect.
Spironolactone: May inhibit diuretic effect.
Probenecid & Sulfinpyrazone : Antagonise uricosuric effect (In doses > 3gm/day - uricosuric effect)
Lab Tests:
Thyroid Function Tests: Increase in PBI
Serum Uric Acid Levels: Increased by levels less than 10 mg/dl and decreased by levels> 10 mg/dl.
Urine Glucose: False negative by glucose oxidase method. False positive results by reduction method.
Urinary Ketones: Produce reddish colour.
Analgesic, antipyretic: 325 - 650mg 3 -4 times daily.
Anti-inflammatory, Arthritis: 3 g / day in divided doses increases the dose if needed.
Maintenance: 3.6 - 5.4 g / day in divided doses.
Rheumatic fever: 4.9 - 7.8 g / day in 3 - 4 divided doses for 1- 2 weeks
For prophylaxis of venous thromboembolism after total hip replacement: 650 mg twice a day started 1 day before surgery and continued for 2 weeks.
For other platelet aggregation inhibitory uses: 325 to 1300 mg daily according to individual needs.
For migraine: 300 - 600 mg to be taken at the first sign of migraine attack and repeated 4 - 6 hourly until suppress mild attacks.
Children:
Arthritis: 60 - 130 mg / kg body weight /day in divided doses
Anti-inflammatory: 60 - 125 mg / kg daily in 4 - 6 hours
Analgesic and Antipyretic: Adults: 1 to 2 tablets (325 to 650 mg) orally every 4 hours.
Children under 12: 10 to 15 mg/kg every 6 hours, not to exceed total daily dose of 2.4 g.
Noscapine
2. Drowsiness
3. Nausea
4. Bronchoconstriction
5. Rashes.
2. Bronchial asthma
3. Along with alcohol or CNS depressants.
2.Irritant dry cough
3.Bronchitis
4.Tracheitis
5.Viral infections of the upper respiratory tract
6.Pertussis (Whooping cough)
(5ml syrup contains 15mg Noscapine)
Adults: 15 to 30mg up to 4 times daily.
Children (6 to 12years): 7.5 to 15mg up to 4 times daily.
Children (2 to 6years): 3.75 to 7.5 mg up to 4 times daily.
Chlorpheniramine Maleate
Pseudoephedrine
2. Tachycardia
3. Arrhythmias
4. CNS stimulation
5. Restlessness
6. Insomnia
7. Anxiety
8. Tremors
9. Skin rashes
10. Urinary retention
11. Respiratory difficulties
2. Severe hypertension
3. Coronary artery disease
4. Patients taking monoamine oxidase inhibitors (MAOIs) or who have taken MAOIs within the previous 14 days
5. Extended release preparations are contraindicated in children below 12 years
2. Cardiac diseases
3. Diabetes
4. Glaucoma
5. Prostatic hyperplasia
6. Hyperthyroidism
2.Upper respiratory tract congestion
3.Adjunctive therapy in symptomatic relief of common cold, allergic rhinitis, blocked Eustachian tube, and upper respiratory tract infections
Adults and children over 12 years: 60mg 3 to 4 times daily
Maximum dose: 240mg/day
Children (age 6 to 12): 30mg 3 to 4 times daily
Maximum dose: 120mg/day
Children (age 2 to 6): 15mg 3 to 4 times daily
Maximum dose: 60mg/day or 4mg/kg.
Over dosage and poisoning: Provide symptomatic treatment and supportive measures. Perform emesis and gastric lavage within 4 hours of ingestion. If renal function is adequate forced diuresis will increase elimination of the drug. (Do not force diuresis in severe poisoning). Monitor and assist vital signs, cardiac state and electrolyte balance. Treat cardiac toxicity with Propranolol or other effective drugs. Treat seizures with Diazepam (I.V.) and give dilute Potassium chloride solution for hypokalaemia.
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