Sample records for bromhexine


    Dhoka Madhura Vishal


    Full Text Available Two accurate, precise, rapid and economical methods were developed and validated for the estimation of Amoxicillin Trihydrate and Bromhexine Hydrochloride in Bulk and combined Pharmaceutical Dosage Form. First method is First order Derivative method, wherein wavelengths selected for quantitation were 283 nm, for Amoxicillin Trihydrate and 218.6 nm, for Bromhexine Hydrochloride. Second method is area under curve method wherein two wavelength ranges chosen were 271-274nm and 244-248nm for Amoxicillin trihydrate and Bromhexine hydrochloride respectively. In both of the methods linearity for detector response was observed in the concentration range of 100-300μg/ml for Amoxicillin Trihydrate and 2-10μg/ml for Bromhexine Hydrochloride. The proposed methods were successfully applied for the simultaneous determination of both drugs in capsule dosage form. The results of the analysis have been validated statistically and by recovery studies.


    Dhoka Madhura Vishal; Gawande Vandana Tukaram; Joshi Pranav Pramod


    Two accurate, precise, rapid and economical methods were developed and validated for the estimation of Amoxicillin Trihydrate and Bromhexine Hydrochloride in Bulk and combined Pharmaceutical Dosage Form. First method is First order Derivative method, wherein wavelengths selected for quantitation were 283 nm, for Amoxicillin Trihydrate and 218.6 nm, for Bromhexine Hydrochloride. Second method is area under curve method wherein two wavelength ranges chosen were 271-274nm and 244-248nm for Amoxi...

  3. Efficacy of Pilocarpine and Bromhexine in Improving Radiotherapy-induced Xerostomia


    Background and aims. Xerostomia is one of the most common complications of head and neck radiotherapy. The aim of this study was to evaluate and compare the efficacy of pilocarpine and bromhexine in improving radiotherapy-induced xerostomia and its associated symptoms. Materials and methods. In this single-blind, randomized crossover study, pilocarpine and bromhexine tablets were used by twenty-five patients suffered from xerostomia, with a medical history of head and neck radiotherapy. At st...

  4. Development and evaluation of bromhexine hydrochloride floating microparticulates

    S L Harikumar


    Full Text Available The main objective of the present study is to prepare floating microsphere of the bromhexine hydrochloride in order to achieve gastro-retention which may result in the improvement of bioavailability and solubility as the bromhexine is soluble up to the pH range of 1-4. The microsphere is prepared by the non-aqueous solvent evaporation method using hydroxyl propyl methyl cellulose and ethyl cellulose in different drug polymer ratios. The in vitro release is studied in the USP dissolution apparatus type I. The percentage yield is more than 60% for the all the batches. The entrapment efficiency increased by increasing the polymer concentration and found to be maximum at 1:4 drug polymer ratios. The drug loading was found to be in the range of the 19.30-33.70%. All the batches show in vitro buoyancy percentage in the range of the 53.3% to 70.13% after 12 h. The in vitro dissolution and permeation studies revealed that the formulations followed zero order release pattern and ′n′ values derived from the PEPPAs equation confirmed that the drug release from the floating system was the non-Fickian transport mechanism. The SEM studies revealed that the drug adsorbed on the surface of the microspheres can able to provide the burst effect in order to provide the immediate therapeutic effect. Therefore, the floating microspheres were able to be buoyant up to 12 h, having excellent flow properties, and met the required drug release kinetics for gastro-retentive systems.

  5. Simultaneous determination of salbutamol sulphate and bromhexine hydrochloride in tablets by reverse phase liquid chromatography

    Pai P. N. S.


    Full Text Available A simple reverse phase liquid chromatographic method has been developed and subsequently validated for simultaneous determination of salbutamol sulphate and bromhexine hydrochloride. The separation was carried out using a mobile phase consisting of acetonitrile, methanol and phosphate buffer, pH 4 in the ratio 60:20:20 v/v. The column used was SS Wakosil-II C-18 with a flow rate of 1 ml/min and UV detection at 224 nm. The described method was linear over a concentration range of 10-110 µg/ml and 20-140 µg/ml for the assay of salbutamol sulphate and bromhexine hydrochloride, respectively. The mean recovery was found to be 95-105% for salbutamol sulphate and 96.2-102.1% for bromhexine hydrochloride when determined at five different levels.

  6. Preparation and evaluation of doxycycline hydrochloride and bromhexine hydrochloride dosage forms for pigeons / Marga le Roux

    Le Roux, Marga


    Objective: To prepare and evaluate three different dosage forms, containing doxycycline hydrochloride (HCI) and bromhexine hydrochloride (HCI) respectively and in combination, for the treatment of respiratory diseases in pigeons. Background: Birds have held a place in man's affection since the ancient Egyptians and Romans kept birds. Europeans have successfully bred birds, especially smaller birds and pigeons, for centuries. Only in recent years, however, have science and me...

  7. [The stability of bromhexine and the structure of its degradation products].

    Göber, B; Lisowski, H; Franke, P


    Refluxed acid or neutral aqueous solutions of Bromhexine (1) show four degradation products. 1 is decomposed at room temperature (20 degrees C; 1 year) less than 1%. Degradation products of crystalline 1 are not detectable in the temperature-moisture-test. Under normal storage conditions a 5-year stability for aqueous solutions and a more than 10-year stability for crystalline 1 are estimated. Very small amounts of three degradation products were isolated by TLC. According to MS-, UV- and IR-analysis their structures are 3-cyclohexyl-6,8-dibromo-chinazoline-4-one (2a), 3-cyclohexyl-6,8-dibromo-chinazoline (2b) and 3-amino-4,6-dibromo-benzaldehyde (3). The structure of N-Methylcyclohexylamine is supposed for a further product. Ms fragmentation and degradation mechanisms are discussed. PMID:3375295

  8. Formulation and Evaluation of Orodispersible Films of Bromhexine HCl - A Patient Friendly Approach

    Anita Pandurang Ayre


    Full Text Available The present investigation was carried out with the objective of formulating orodispersible forms of the mucolytic drug, Bromhexine HCl to enhance convenience and compliance to the elderly and paediatric patients for better therapeutic efficacy. Orodispersible films of Bromhexine HCl were prepared by solvent evaporation technique. Formulation studies were carried out using different polymer combinations, the obtained films were evaluated for their appearance, color, elegance, continuity, texture, presence of air bubbles, stickiness to Petri dish, cracks, cuttings, and imperfections. Alginate and HPMC based films recorded the fastest disintegration when used alone and in mixtures with PVP-K25 and maltodextrin. Xanthan gum film had the longest disintegration time. Moreover, adding xanthan gum, Na CMC, and carbopol prolonged the disintegration time of HPMC and alginate films. A good correlation existed between the calculated dissolution rate of each film and its disintegration time. Formulas F1and F7 showed the highest resistance against moisture absorption and recoded tensile strength values of 15.47 and 17.16 kg/mm2, respectively after storage. Films based on HPMC alone or in combination with other polymers exhibited high resistance against moisture absorption except with Na CMC. Alginate and xanthan gum based films had a higher affinity for moisture absorption. The addition of maltodextrin significantly decreased the percentage moisture absorption after storage at 97% relative humidity. This effect was concentration-dependent. Thus disintegration time of film was 25 s, drug content 92.4 % and drug release was 96.3 %. The developed formulation was found to be stable under the conditions tested.

  9. Deposition and clearance of monodisperse aerosols in the calf lung: effects of particle size and a mucolytic agent (bromhexine)

    Davies, C P; Webster, A J


    Mucociliary clearance and retention of monodisperse aerosols of radiolabelled polystyrene particles of both 3.3 microns and 5 microns diameter were investigated in four healthy calves and two sick calves. The effect of the mucolytic agent bromhexine was also assessed at two dosage levels. There were significant differences (P less than 0.05) in clearance rate constant between calves, but similar patterns of clearance for each calf. These characteristics of mechanical lung clearance did not vary over a two month period. Values of clearance rate constant and percentage retention varied significantly (P less than 0.001) between the two different particle sizes, 5 microns particles giving faster clearance and lower retention of particles than 3.3 microns particles. Bromhexine at the recommended dose of 1.6 mg/kg 0.75 caused a significant (P less than 0.05) increase in clearance rate in both healthy and sick calves, but affected percentage retention only in sick calves. This study illustrates the variation in mucociliary clearance rates shown by individuals and also underlines the importance of particle size in aerosols used for studies of pulmonary deposition and clearance. The work also indicates that bromhexine may be of use in the therapy of respiratory disease in calves. PMID:3651885

  10. Stability-indicating HPLC method for simultaneous determination of terbutaline sulphate, bromhexine hydrochloride and guaifenesin

    A Porel


    Full Text Available The aim of the present study was the development and subsequent validation of a simple, precise and stability-indicating reversed phase HPLC method for the simultaneous determination of guaifenesin, terbutaline sulphate and bromhexine hydrochloride in the presence of their potential impurities in a single run. The photolytic as well as hydrolytic impurities were detected as 3,5-dihydroxybenzoic acid, 3,5-dihydroxybenzaldehyde, 1-(3,5-dihydroxyphenyl-2-[(1,1-dimethylethyl amino]-ethanone from terbutaline, 2-methoxyphenol and an unknown impurity identified as (2RS-3-(2-hydroxyphenoxy-propane-1,2-diol from guaifenesin. The chromatographic separation of all the three active components and their impurities was achieved on Wakosil II column, using phosphate buffer (pH 3.0 and acetonitrile as mobile phase which was delivered initially in the ratio of 80:20 (v/v for 18 min, then changed to 60:40 (v/v for next 12 min, and finally equilibrated back to 80:20 (v/v for 10 min. Other HPLC parameters were: Flow rate at 1.0 ml/min, detection wavelengths 248 and 280 nm, injection volume 10 ml. The calibration graphs plotted with five concentrations of each component were linear with a regression coefficient R 2 >0.9999. The limit of detection and limit of quantitation were estimated for all the five impurities. The established method was then validated for linearity, precision, accuracy, and specificity and demonstrated to be applicable to the determination of the active ingredients in commercial and model cough syrup. No interference from the formulation excipients was observed. These results suggest that this LC method can be used for the determination of multiple active ingredients and their impurities in a cough and cold syrup.

  11. Stability-indicating HPLC Method for Simultaneous Determination of Terbutaline Sulphate, Bromhexine Hydrochloride and Guaifenesin.

    Porel, A; Haty, Sanjukta; Kundu, A


    The aim of the present study was the development and subsequent validation of a simple, precise and stability-indicating reversed phase HPLC method for the simultaneous determination of guaifenesin, terbutaline sulphate and bromhexine hydrochloride in the presence of their potential impurities in a single run. The photolytic as well as hydrolytic impurities were detected as 3,5-dihydroxybenzoic acid, 3,5-dihydroxybenzaldehyde, 1-(3,5-dihydroxyphenyl)-2-[(1,1-dimethylethyl) amino]-ethanone from terbutaline, 2-methoxyphenol and an unknown impurity identified as (2RS)-3-(2-hydroxyphenoxy)-propane-1,2-diol from guaifenesin. The chromatographic separation of all the three active components and their impurities was achieved on Wakosil II column, using phosphate buffer (pH 3.0) and acetonitrile as mobile phase which was delivered initially in the ratio of 80:20 (v/v) for 18 min, then changed to 60:40 (v/v) for next 12 min, and finally equilibrated back to 80:20 (v/v) for 10 min. Other HPLC parameters were: Flow rate at 1.0 ml/min, detection wavelengths 248 and 280 nm, injection volume 10 μl. The calibration graphs plotted with five concentrations of each component were linear with a regression coefficient R(2) >0.9999. The limit of detection and limit of quantitation were estimated for all the five impurities. The established method was then validated for linearity, precision, accuracy, and specificity and demonstrated to be applicable to the determination of the active ingredients in commercial and model cough syrup. No interference from the formulation excipients was observed. These results suggest that this LC method can be used for the determination of multiple active ingredients and their impurities in a cough and cold syrup. PMID:22131621

  12. Kinetic and analytic investigations on the formation of N-nitroso-N-methyl-N-cyclohexylamine from bromhexine and nitrite.

    Schmid, J; Daneck, K; Koss, F W; Eisenbrand, G; Schlemmer, K H


    Bromhexine (N-methyl-N-cyclohexyl-(2-amino-3,5-dibromobenzyl)-ammoniumhydr ochloride) forms N-nitroso-N-methyl-N-cyclohexylamine (NMCA) under the conditions of the WHO Nitrosation Assay Procedure (NAP-test). The formation kinetics of this compound was investigated. The formation of NMCA depends on the square of the nitrite concentration. The reaction has a narrow pH-optimum at pH 3. The reaction is quick: After 1 h about 70% of the maximum amount of NMCA is formed. To study this reaction kinetics sensitive assays with a detection limit up to 0.5 ng/ml NMCA were developed. The stability of the components of the system, especially that of NMCA and nitrite, were further studied. The latter is rather instable under conditions found in an acidic stomach. PMID:3272140

  13. Determination of bromhexine in cough-cold syrups by absorption spectrophotometry and multivariate calibration using partial least-squares and hybrid linear analyses. Application of a novel method of wavelength selection.

    Goicoechea, H C; Olivieri, A C


    The mucolitic bromhexine [N-(2-amino-3,5-dibromobenzyl)-N-methylcyclohexylamine] has been determined in cough suppressant syrups by multivariate spectrophotometric calibration, together with partial least-squares (PLS-1) and hybrid linear analysis (HLA). Notwithstanding the spectral overlapping between bromhexine and syrup excipients, as well as the intrinsic variability of the latter in unknown samples, the recoveries are excellent. A novel method of wavelength selection was also applied, based on the concept of net analyte signal regression, as adapted to the HLA methodology. This method allows one to improve the performance of both PLS-1 and HLA in samples containing nonmodeled interferences. PMID:18967655

  14. 溴己新治疗慢性支气管炎的疗效评价%Curative effect evaluation of bromhexine for the treatment of chronic bronchitis

    邓梓辛; 张美祥; 谭璐; 汪曲; 王树平


    Objective To assess the effect and safety of bromhexine for chronic bronchitis .Methods We retrieve the database inclu‐ding PubMed ,the Cochrane library ,China National Knowledge Internet (CNKI) ,Weip Database (VIP) and Wanfang Data . Eight randomized controlled trials (RCT ) comparing bromhexine with ambroxol ,Erchentang ,Kechuanning oral liquid ,S‐carboxy‐methylcysteine and placebo were included in this research .The course of treatment was more than 5 days .The Jadad quality tools was used for the quality evaluation of each study .Results There were 4 RCTs which compared bromhexine with ambroxol ,with significant difference in clinical overall efficacy [RR=0 .83 ,95% CI(0 .76 ,0 .91) ,P<0 .000 1] .The rest groups required descrip‐tive analysis for study quantity .Conclusion Chronic bronchitis can be treated effectively by bromhexine .However ,compared with ambroxol ,the result of quality grade and Meta‐analysis reveals lower curative effect .%目的:评价溴己新治疗慢性支气管炎的疗效及安全性。方法通过检索PubMed、Cochrane library、中国期刊全文数据库(China National Knowledge Internet ,CNKI)、维普数据库(Weip Database ,VIP)和万方数字化期刊全文数据库;纳入随机对照试验(Randomized Controlled Trial ,RCT)8篇,包括溴己新对比氨溴索、二陈汤、咳喘宁口服液、S‐羧甲半胱氨酸和安慰剂组;利用Jadad质量评分工具进行方法质量评价。结果溴己新组对比氨溴索组共4个RC T ,临床总有效率比较:R R=0.83,95% C I (0.76,0.91),P<0.0001,差异有统计学意义。其余组由于文献数量少限制而进行描述性分析。结论溴己新可以有效地治疗慢性支气管炎,但是质量评分以及Meta分析显示其疗效低于氨溴索。

  15. Effect of drug content and agglomerate size on tabletability and drug release characteristics of bromhexine hydrochloridetalc agglomerates prepared by crystallo-co-agglomeration.

    Jadhav, Namdeo; Pawar, Atmaram; Paradkar, Anant


    The objective of the investigation was to study the effect of bromhexine hydrochloride (BXH) content and agglomerate size on mechanical, compressional and drug release properties of agglomerates prepared by crystallo-co-agglomeration (CCA). Studies on optimized batches of agglomerates (BXT1 and BXT2) prepared by CCA have showed adequate sphericity and strength required for efficient tabletting. Trend of strength reduction with a decrease in the size of agglomerates was noted for both batches, irrespective of drug loading. However, an increase in mean yield pressure (14.189 to 19.481) with an increase in size was observed for BXT2 having BXH-talc (1:15.7). Surprisingly, improvement in tensile strength was demonstrated by compacts prepared from BXT2, due to high BXH load, whereas BXT1, having a low amount of BXH (BXH-talc, 1:24), showed low tensile strength. Consequently, increased tensile strength was reflected in extended drug release from BXT2 compacts (Higuchi model, R(2) = 0.9506 to 0.9981). Thus, it can be concluded that interparticulate bridges formed by BXH and agglomerate size affect their mechanical, compressional and drug release properties. PMID:20228039

  16. Cyclodextrins

    Stojanov, Mladen; Mørck Nielsen, Hanne; Larsen, Kim Lambertsen


    Bromhexine hydrochloride (bromhexine) is a mucolytic agent with very low aqueous solubility. However, with addition of cyclodextrins (CD) to the formulation, this disadvantage may be limited and therapeutic doses of bromhexine in solution can be achieved. The interaction of bromhexine with α-, β-...

  17. Drug: D07542 [KEGG MEDICUS

    Full Text Available D07542 Drug Bromhexine (INN); Fluibron (TN) C14H20Br2N2 373.9993 376.13 D07542.gif Expectorant A ... assification [BR:br08303] R RESPIRATORY SYSTEM R05 COUGH ... AND COLD PREPARATIONS R05C EXPECTORANTS, EXCL. COM ... BINATIONS WITH COUGH ... SUPPRESSANTS R05CB Mucolytics R05CB02 Bromhexine D ...

  18. Drug: D01778 [KEGG MEDICUS

    Full Text Available D01778 Drug Bromhexine hydrochloride (JP16/USAN); Bisolvon (TN) C14H20Br2N2. HCl 409.976 412.590 ... assification [BR:br08303] R RESPIRATORY SYSTEM R05 COUGH ... AND COLD PREPARATIONS R05C EXPECTORANTS, EXCL. COM ... BINATIONS WITH COUGH ... SUPPRESSANTS R05CB Mucolytics R05CB02 Bromhexine D ...

  19. Simultaneous Determination of Guaifenesin, Bromhexine and Ambroxol in Human Plasma by LC-MS/MS and Its Pharmacokinetic Studies%LC-MS/MS同时测定愈创甘油醚、溴己新和氨溴索及人体药动学中的应用

    葛庆华; 周臻; 支晓瑾; 马丽丽; 丁存刚


    目的 建立同时测定人血浆中愈创甘油醚、溴己新和氨溴索浓度的LC-MS/MS方法,并应用于人体药动学研究.方法 以盐酸维拉帕米为内标,血浆样品经液.液提取后经C18柱分离,流动相:甲醇-16 mmol·L醋酸铵缓冲液(50:50,甲酸调pH 3.8),流速0.22mL·min-1.采用SEI源正离子模式,多反应监测(MRM)方式进行定量分析,监测离子分别为199.1→125(愈创甘油醚),374.9→114.1(溴己新)、378.9→264(氨溴索).结果 线性范围分别为愈创甘油醚10.0~5 000 μg·L,溴己新、氨溴索为0.2~100μg·L-1.3种药物的日内、日间精密度小于11%,方法回收率在97%~108%之间.结论 该法灵敏、准确、快速,并成功用于复方制剂的药动学研究.

  20. Nasal mucociliary clearance in patients with tracheostomy

    Yadav, S. P. S.; Janab, Khan Shariq; Singh, Jagat; Ranga, Rupender K.


    Nasal mucociliary clearance (NMC) time was estimated in 30 tracheostomized patients (24 males & 6 females) in the age group of 13–55 years which was 7.04±0.38 minutes: The patients suffering from nose and paranasal sinus disorders; taking drugs like bromhexine; undergoing radiotherapy and smokers were excluded from the study. The nasal mucociliary clearance in 30 age & sex matched healthy controls was 9.16±0.62 minutes. The NMC was found to he significantly lowered in patients with tracheosto...


    Ф. Т. Малыхин


    Full Text Available Russia is among the countries where using of mucolytic drugs in clinical practice is widespread. In chronic bronchitis, chronic obstructive pulmonary disease, acute respiratory syndrome with prolonged cough, pneumonia, tuberculosis and many other pathologies using of expectorants and mucoregulating drugs is common. Among the synthetic mucolytics benzyalamine bromhexine has been introduced for a long time in practice; and then its derivative — ambroxol hydrochloride which has better pharmacokinetics and pharmacodynamics. Using of ambroxol (Ambrobene in patients with cough, accompanied by difficult expectoration, is useful as it promotes the implementation of the protective cough reflex, providing evacuation of viscous mucus or foreign particles from the respiratory tract.

  2. Recent developments in the treatment of alcoholic chronic pancreatitis.

    Tsujimoto, Tatsuhiro; Kawaratani, Hideto; Yoshiji, Hitoshi; Uemura, Masahito; Fukui, Hiroshi


    Chronic pancreatitis is a progressive inflammatory condition characterized by repeated attacks of abdominal pain, and the destruction and fibrosis of the pancreatic parenchyma which causes to reduced exocrine and endocrine functions. Alcohol is the most common cause of chronic pancreatitis. Although abstinence is usually considered a prerequisite for successful treatment of alcoholic chronic pancreatitis, we often encounter patients who have repeated attacks from the compensated stage through the transitional stage. In alcoholic chronic pancreatitis, continued alcohol consumption causes changes in the digestive hormones and vagal nerve function that induce the pancreatic acinar cells to oversecrete protein, increasing the protein concentration and viscosity of the pancreatic juice. This induces protein sedimentation from the pancreatic juice and formation of protein plugs within the pancreatic duct, triggering repeated attacks of acute pancreatitis. The treatment of alcoholic chronic pancreatitis includes alleviation of symptoms, particularly abdominal pain, elimination of trigger factors, prevention of recurrence and disease progression, adjuvant therapies for pancreatic exocrine and endocrine failure. Recently, the main constituent proteins in these protein plugs have been identified, enabling trials of several therapies, such as the administration of secretin formulations and endoscopic removal. Bromhexine hydrochloride, a bronchial mucolytic, has an affinity for the pancreatic acinar cells, inducing them to secrete pancreatic juice of low viscosity. In this review, we summarize the most recent thoughts about alcoholic chronic pancreatitis, and the new treatments, and in particular, we present our findings concerning the efficacy of bromhexine hydrochloride in the treatment of this disease. PMID:19630718


    Patil Arun


    Full Text Available In the present study, hot melt technique has been evaluated as a tool to mask bitter or unpleasant taste of Bromhexine hydrochloride and Salbutamol sulphate formulated as pellets. Bees wax and cetyl alcohol were evaluated as hot melt coating materials for taste masking. Drug containing pellets were prepared and coated using hot melt technique. Threshold bitterness concentrations of drugs and taste evaluation of hot melt coated pellets were determined by panel method. The pellets of all the formulation batches were in the size range of 825 to 995 μ after hot melt coating. Pellets exhibited uniformity of content in the range of 97.6 – 101.1%. Threshold bitterness concentration of both the drugs was found to be about 300 µg/ml. Amount of drug released from all pellets batches was less than threshold bitterness concentration for first 5 minutes indicating that taste of the drug was completely masked. Taste evaluation study of hot melt coated pellets by panel method revealed that about 80 % of the volunteers sensed no bitter taste even at 2 and 3% coating level whereas none of the volunteer reported bitter taste for pellets coated at 5%w/w level. Bees wax and cetyl alcohol both found to be better taste masking agents for Bromhexine hydrochloride and Salbutamol sulphate, when used by hot melt technique.

  4. [Simultaneous determination of three components in compound clorprenaline tablet by using the derivative-complementary tristimulus method].

    Li, Q Y; Zhuo, Z L; Chen, Y W


    Clorprenaline hydrochloride (a), bromhexine hydrochloride (b) and decloxizine hydrochloride (c) are three main components in clorprenaline compound tablet. The serious overlapping bands of their absorption spectra cause the interference in the determinations, especially the component of (a) which has both minor content and low absorption coefficient, thus making the analysis difficult. In this paper, the interference from matrix is eliminated by using first order derivative transformation. In combination with complementary tristimulus method and with the technique of additions, the concentrations of three components in tablets can be successfully determined simultaneously. A software developed in this laboratory makes possible the ease of parameter selection, reporting data in various formats and printing figures of dissolution process, showing a clear locus. This method will be of value to quality control in manufacturing process and to the research of the dissolution dynamics of tablets in simulated stomach. PMID:2284956

  5. [Pharmacological treatment of acute cough].

    Småbrekke, Lars; Melbye, Hasse


    Acute cough may cause considerable distress for patients with upper airway infections, and is a symptom commonly presented to doctors. We wanted to assess the evidence basis for pharmacological treatment of this condition. Predefined terms (MeSH and Emtree) and free text were used to search PubMed and Embase for double-blind randomized trials, reviews and guidelines. Little evidence supports the use of guaifenesine, bromhexine and acetylcysteine for acute cough associated with upper airway infections. Likewise, there is insufficient evidence to decide whether noscapine, codeine and ehylmorphine are beneficial for acute cough on this indication. Well-designed randomized controlled trials with valid outcomes are needed to document possible benefits of treatment. Treatment with codeine or ethylmorphine may be at the expense of adverse effects, abuse or dependence. PMID:19448753

  6. [Effect of various phytotherapeutic expectorants on mucociliary transport].

    Müller-Limmroth, W; Fröhlich, H H


    The normal transport velocity of the isolated ciliated epithelium of the frog oesophagus was proved to be 228 +/- 15 micron . s-1. Bromhexin increased this transport rate 1.34 fold and KNEIPP-Hustentee 1.38 fold. The components of the cough tea had different effects on the mucociliar activity. The following ingredients increased the transport rate with falling rank order: Folia farfarae (coltsfoot), fructus foeniculi (fennel), and fructus anisi (anise). Herba plantaginis (plantain), flores verbasci (torch weed), and radix liquiritiae (liquorice) were ineffective whereas semen foenigraeci (foenugrec), radix althaeae (marsh mallow), and herba thymi (mother of thyme) had an inhibiting effect in raising rank order. The latter two groups of ingredients are constituents of the tea because of their attributed additional effects, e.g. protective effects due to mucous layers in the hypopharynx and spasmolytic, secretolytic and bactericide effects. PMID:7364365

  7. Rose bengal score--a possible key parameter when evaluating disease level and progression in primary Sjögren's syndrome.

    Prause, J U; Kriegbaum, N J; Manthorpe, R; Oxholm, P


    The rose bengal score is one of the most commonly used tests for evaluation of ocular surface epithelial damage. The test is used in most Sjögren's syndrome criteria. We examined 24 female and four male patients with primary Sjögren's syndrome (primary SS) in order to evaluate possible correlation between the various tests for keratoconjuncivitis sicca (KCS), and for possible correlations to xerostomia and p-IgG levels. Among the KCS tests a high rose bengal score appeared to be the key parameter, being correlated to low break-up time (P less than 0.01), low tear lysozyme (P less than 0.01), appearance of snake-like chromatin in conjunctival imprints (P less than 0.05), low sialometry (P greater than 0.01) and high p-IgG (P less than 0.01). We followed another group of patients with primary SS (30 females and four males) for a mean period of 53 (range 27-76) months. The patients were divided according to their initial response to systemic treatment with bromhexine. KCS parametres and p-IgG were measured repeatedly during the observation period. Patients responding to and continuously treated with bromhexine (2/3 of patients) improved significantly (P less than 0.05) in rose bengal score, but had increasing levels of p-IgG. Non-responders kept their low tear-production rate and had also increasing p-IgG levels. However, when subdivided according to p-IgG level, the group of patients with relatively low p-IgG improved in rose begal score, whereas the high p-IgG-group increased in rose bengal score. The rose bengal score appears to be a useful key parameter when evaluating disease level and progression. PMID:2789651

  8. Crystallo-co-agglomeration: A novel particle engineering technique

    Paradkar Anant


    Full Text Available Crystallo-co-agglomeration (CCA is a novel particle engineering/design technique developed by Kadam et al, to overcome the limitations of spherical crystallization (SC. Basically, it′s single step process used for size enlargement of single, two or more, small dose or large dose drugs, in combination with or without diluent. The process of CCA involves simultaneous crystallization and agglomeration of drug/s with/without excipients/s from good solvent and/or bridging liquid by addition of a non-solvent. Till date CCA has been applied for spherical agglomeration of talc, bromhexine hydrochloride-talc, ibuprofen-talc, ibuprofen-paracetamol, and naproxen-starch. The spherical agglomerates obtained by CCA can be used as intact beads (encapsulated spansules or directly compressible tablet intermediates having satisfactory micromeritic (flowability, mechanical (friability, crushing, compressional (compressibility, compactibility, and drug release properties. Modified drug release from agglomerates and compacts thereof can be achieved using suitable polymer composition in the process design. Thus, it can be concluded that, CCA is a simple and cost effective process, which can be tailor-made for particle design of all majority of drugs and combinations thereof.

  9. Evaluation of antitussive agents in man.

    Parvez, L; Vaidya, M; Sakhardande, A; Subburaj, S; Rajagopalan, T G


    Methodology to evaluate the efficacy of antitussive drugs rely largely on subjective methods and cough counts. There are few studies in cough due to natural disease especially using objective techniques. This paper presents data from a series of randomized, double blind, placebo controlled clinical trials in cough due to both chronic bronchopulmonary disease and acute upper respiratory tract infections. In these studies, cough was quantified using a standardized and validated computerized system for the acquisition and multidimensional analysis of the cough sound. Key objective parameters like cough counts, intensity, latency and total effort expended were studied. Guaiphenesin and bromhexine showed significant expectorant effects in patients with productive cough due to chronic bronchopulmonary disease. Differences were observed in speed of action, and objective and subjective measures, that probably indicate differences in drug action. More recently, three studies evaluated the antitussive drug dextromethorphan in non-productive cough due to uncomplicated upper respiratory tract infections. Reproducible cough suppressant effects were demonstrated after a single 30 mg dose using objective measures of cough counts, latency and total effort. These results establish the sensitivity and robustness of the cough quantitation methodology in the objective evaluation of cough treatments. PMID:9232667

  10. Inhibitor screening of pharmacological chaperones for lysosomal β-glucocerebrosidase by capillary electrophoresis.

    Shanmuganathan, Meera; Britz-McKibbin, Philip


    Pharmacological chaperones (PCs) represent a promising therapeutic strategy for treatment of lysosomal storage disorders based on enhanced stabilization and trafficking of mutant protein upon orthosteric and/or allosteric binding. Herein, we introduce a simple yet reliable enzyme assay using capillary electrophoresis (CE) for inhibitor screening of PCs that target the lysosomal enzyme, β-glucocerebrosidase (GCase). The rate of GCase-catalyzed hydrolysis of the synthetic substrate, 4-methylumbelliferyl-β-D: -glucopyranoside was performed using different classes of PCs by CE with UV detection under standardized conditions. The pH and surfactant dependence of inhibitor binding on recombinant GCase activity was also examined. Enzyme inhibition studies were investigated for five putative PCs including isofagomine (IFG), ambroxol, bromhexine, diltiazem, and fluphenazine. IFG was confirmed as a potent competitive inhibitor of recombinant GCase with half-maximal inhibitory concentration (IC(50)) of 47.5 ± 0.1 and 4.6 ± 1.4 nM at pH 5.2 and pH 7.2, respectively. In contrast, the four other non-carbohydrate amines were demonstrated to function as mixed-type inhibitors with high micromolar activity at neutral pH relative to acidic pH conditions reflective of the lysosome. CE offers a convenient platform for characterization of PCs as a way to accelerate the clinical translation of previously approved drugs for oral treatment of rare genetic disorders, such as Gaucher disease. PMID:21286689

  11. Analysis of 76 veterinary pharmaceuticals from 13 classes including aminoglycosides in bovine muscle by hydrophilic interaction liquid chromatography-tandem mass spectrometry.

    Dasenaki, Marilena E; Michali, Christina S; Thomaidis, Nikolaos S


    A multiresidue/multiclass method for the simultaneous determination of 76 veterinary drugs and pharmaceuticals in bovine muscle tissue has been developed and validated according to the requirements of European Commission Decision 2002/657/EC. The analytes belong in 13 different classes, including aminoglycoside antibiotics, whose different physicochemical properties (extremely polar character) render their simultaneous determination with other veterinary drugs quite problematic. The method combines a two-step extraction procedure (extraction with acetonitrile followed by an acidic aqueous buffer extraction) with hydrophilic interaction liquid chromatography-tandem mass spectrometry (HILIC-MS/MS) determination, allowing confirmation and quantification in a single chromatographic run. Further cleanup with solid phase extraction was performed using polymeric SPE cartridges. A thorough ionization study of aminoglycosides was performed in order to increase their sensitivity and significant differences in the abundance of the precursor ions of the analytes were revealed, depending on the composition of the mobile phase tested. Further gradient elution optimization and injection solvent optimization were performed for all target analytes.The method was validated according to the European Commission Decision 2002/657. Quantitative analysis was performed by means of standard addition calibration. Recoveries varied from 37.4% (bromhexine) to 106% (kanamycin) in the lowest validation level and 82% of the compounds showed recovery >70%. Detection capability (CCβ) varied from 2.4 (salinomycin) to 1302 (apramycin) μgkg(-1). PMID:27215463

  12. [Action mechanisms of cough suppressants and their clinical application].

    Płusa, Tadeusz


    Inhaled particles or compacted secretions in the respiratory tract cause irritation of mechanoreceptors, subsequent stimulation of afferent fibers of the vagus nerve, triggering the cough reflex. Distribution of drugs used in the treatment of cough takes into account the pharmacokinetic activity, and this mainly affect on bronchial secretions--drugs that act directly, which destroy disulfide bonds mucous glucoproteins using free sulfhydryl groups and digesting enzymes, extracellular DNA, acting indirectly, that modify the secretion of mucus in the way of other mechanisms, as well as acting on the cough reflex (effects on receptors in the bronchial tree). Mucolytics reduce the viscosity of bronchial secretions by interrupting the sulfide bonds in the mucoprotein chain. Mucokinetic drugs are designed to reduce the adhesion of secretions and facilitate the process of mucociliary clearance by enhancing the potency of cilia. One of the ways of the increasing process is the stimulation of secretion by human neutrophil elastase gene and protein expression regulating this process. The pharmacokinetic properties of these drugs show their high clinical utility and effectiveness in the treatment of respiratory secretions dense clutter. This is possible to reduce the viscosity of mucus by bromhexine. This is obtained by acid depolymerization of the polysaccharide fibers in the bronchial secretions. Synergistic effect with antibiotics of these preparations indicates their permanent place in the treatment of patients with respiratory pathology. PMID:24645580

  13. Bronchiectasis


    Introduction Bronchiectasis is usually a complication of previous lower respiratory infection, and causes chronic cough and copious production of sputum, which is often purulent. Bronchiectasis may cause signs of chronic obstructive pulmonary disease. It can also be associated with cystic fibrosis and other congenital disorders, foreign body inhalation, and other causes of lung damage. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical question: What are the effects of treatments in people with bronchiectasis but without cystic fibrosis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2011 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We performed a GRADE evaluation of the quality of evidence for interventions. Results We found 19 systematic reviews, RCTs, or observational studies that met our inclusion criteria. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: anticholinergic therapy, beta2 agonists, bronchopulmonary hygiene physical therapy, corticosteroids (inhaled, oral), exercise or physical training, hyperosmolar agents (inhaled), leukotriene receptor antagonists, methyl-xanthines (oral), mucolytics (bromhexine or deoxyribonuclease), prolonged-use antibiotics, and surgery. PMID:21846412

  14. [Pharmacological effects of N-acetyl-L-cysteine on the respiratory tract. (I). Quantitative and qualitative changes in respiratory tract fluid and sputum (author's transl)].

    Kogi, K; Saito, T; Kasé, Y; Hitoshi, T


    The following three experiments were performed to determine the effects of N-acetyl-L-cysteine (NAC) on the quantity and quality of respiratory tract fluid (RTF) and sputum. All drugs used were administered into the stomach through a gastric tube. 1) Indirect measurement of bronchial secretion in rats, which was expressed by the amounts of dye excreted into the respiratory tract, was carried out according the the Sakuno's method, with some modification. Some expectorants of the secretomotor type, such as bromhexine and pilocarpine, significantly increased the secretion, even at low doses. On the other hand, mucolytic agents such as NAC augmented the secretion only in doses of 500 to 1500 mg/kg. 2)As a direct method of measurements, Kasé's modification of Perry and Boyd's method was used to collect RTF, quantitatively, from rabbits. The RTF of healthy rabbits was colorless and watery. The administration of NAC in doses of 500 to 1500 mg/kg augmented the output volume and RTF became slightly turbid, probably due to an increase in the viscous mucus. 3) Rabbits with subacute bronchitis were prepared by long-term exposure to air contaminated with SO2 gas and sputa were collected before and after administration of NAC, respectively, according to the Kase's method. The sputa were opalescent and viscous gel included nodular masses. The administration of NAC, 1000 and 1500 mg/kg resulted in a dose dependent decrease in the relative viscosity. The percent-decreased in viscosity with NAC was statistically correlated with that in amounts of dry matter, those in protein and polysaccharide in the sputa. From the results described above, it was concluded that NAC given into the stomach can liquefy sputum by splitting mucoprotein disulphide linkages, that is, altering the rheological characteristics of sputum to facilitate expectoration. PMID:7286849

  15. Amoxycillin and clavulanic acid induced Stevens-Johnson syndrome: a case report

    Ravi Shankar Manchukonda


    Full Text Available Stevens-Johnson syndrome (SJS is an immune complex mediated hypersensitivity complex that typically involves the skin and the mucous membranes. Various etiologic factors (e.g., infection, drugs and malignancies have been implicated as causes of Stevens-Johnson syndrome. However, as many as half of the cases are idiopathic. Bastuji and Roujeau proposed that the denomination of Stevens-Johnson syndrome should be used for a syndrome characterized by mucous membrane erosions and widespread small blisters that arise on erythematous or purpuric maculae that are different from classic targets. In this case report, a 6 year old girl who was administered a cough syrup (containing bromhexine, guaiphenesin, diphenhydramine and phenylephrine and amoxycillin and clavulanic acid dispersible tablet for the treatment of cough developed pruritic skin eruptions all over the body along with painful erosions on the tongue, buccal mucosa, genital and anal mucosa. A diagnosis of Stevens-Johnson syndrome was made. Amoxycillin and clavulanic acid combination was identified as the culprit based on the temporal relationship between the drug administration and the appearance of the rashes and based on a number of SJS reports implicating amoxycillin and clavulanic acid having been published before. The cough syrup and amoxycillin and clavulanic acid combination tablets were immediately stopped. Symptomatic treatment was administered. The child improved and was later discharged. Causality assessment using Naranjo adverse drug reaction probability scale revealed that amoxycillin and clavulanic acid combination was a possible cause for the harmful cutaneous adverse reaction with a score of 4. [Int J Basic Clin Pharmacol 2016; 5(3.000: 1140-1144

  16. Tetrahymena pyriformis in the ciliate mobility test. Validation and description of a testing procedure for the registration of harmful substances in the air as well as the effects of cigarette smoke on the human respiratory ciliated epithelium.

    Gräf, W; Gräf, H; Wenz, M


    The damage of the human respiratory ciliated epithelium or its ciliar activity caused by mixtures of harmful substances in the air and cigarette smoke is a considerable parameter for the judgment of acute harmful influences on the human respiratory tract. As an immediate measuring or a quantitative statement about the influence on cilia in vivo at human beings is extremely difficult and problematic, a convenient model experimental system in form of the so called ciliate mobility test (CMT) has been used. In this connection the influence on cilia of the protozan single-celled organism Tetrahymena pyriformis, regarding its average speed of locomotion has been taken as standard. The proof, that the cilia are identical in morphological and functional respect at the human ciliated epithelium and at T. pyriformis has been reached by electron optical comparative representation and bibliographical known substances, influencing cilia (theophylline, bromhexine, ambroxol, terpin hydrate, mercaptoethanesulfonat-sodium, amrinon, salbutamol, tetracosactid-hexaacetate, histamine, and phenol). With regard to the comparability and applicability to the human respiratory ciliated epithelium we have been able to gain statements by means of the CMT. By constructing a special reaction vessel the influence of harmful gases at a thin layer of ciliate culture suspension (1 cm) for a standardised exposure time (1 hour) has been made possible and with that a model for the comparability with the conditions of the human respiratory ciliated epithelium has been created. A number of harmful gases, that are relevant in the air hygiene (CO, CO2, N2, N2O, NO2, O3, SO2) as well as cigarette smoke at active smokers (primary stream smoke) and the inhalation of the smoke of other people's cigarettes has been tested. It turned out, that especially NO2 (nitric oxide) shows a high ciliar toxicity, while the controversially discussed ozone (O3) has not resulted in detraction of cilia. CO, N2O and SO2 have

  17. Non-parametric linear regression of discrete Fourier transform convoluted chromatographic peak responses under non-ideal conditions of internal standard method.

    Korany, Mohamed A; Maher, Hadir M; Galal, Shereen M; Fahmy, Ossama T; Ragab, Marwa A A


    This manuscript discusses the application of chemometrics to the handling of HPLC response data using the internal standard method (ISM). This was performed on a model mixture containing terbutaline sulphate, guaiphenesin, bromhexine HCl, sodium benzoate and propylparaben as an internal standard. Derivative treatment of chromatographic response data of analyte and internal standard was followed by convolution of the resulting derivative curves using 8-points sin x(i) polynomials (discrete Fourier functions). The response of each analyte signal, its corresponding derivative and convoluted derivative data were divided by that of the internal standard to obtain the corresponding ratio data. This was found beneficial in eliminating different types of interferences. It was successfully applied to handle some of the most common chromatographic problems and non-ideal conditions, namely: overlapping chromatographic peaks and very low analyte concentrations. For example, a significant change in the correlation coefficient of sodium benzoate, in case of overlapping peaks, went from 0.9975 to 0.9998 on applying normal conventional peak area and first derivative under Fourier functions methods, respectively. Also a significant improvement in the precision and accuracy for the determination of synthetic mixtures and dosage forms in non-ideal cases was achieved. For example, in the case of overlapping peaks guaiphenesin mean recovery% and RSD% went from 91.57, 9.83 to 100.04, 0.78 on applying normal conventional peak area and first derivative under Fourier functions methods, respectively. This work also compares the application of Theil's method, a non-parametric regression method, in handling the response ratio data, with the least squares parametric regression method, which is considered the de facto standard method used for regression. Theil's method was found to be superior to the method of least squares as it assumes that errors could occur in both x- and y-directions and

  18. Analysis of the evidence of efficacy and safety of over-the-counter cough medications registered in Brazil

    Adriano Max Moreira Reis


    Full Text Available The objective of this study was to analyze the level of evidence regarding the efficacy, effectiveness and safety of over-the-counter (OTC cough medications registered in Brazil. The National Health Surveillance Agency database was used to identify the drugs. Clinical trials, systematic reviews, meta-analyses, and studies on safety were searched on the Medline baseline, the Cochrane Library and SIETES (System of Essential Information in Therapeutics and Health; database in Spanish. Most drugs (62.5% were sold as a fixed-dose combination of two or more drugs. Randomized clinical trials were found for only three drugs: bromhexine, dextromethorphan and guaifenesin. No clinical trials were found for fixed-dose combinations. Systematic reviews on Cochrane did not report any evidence in favor of or against the effectiveness of cough drugs. Efficacy is also unclear, especially regarding fixed-dose combinations. The evidence for the efficacy of OTC cough medications available in Brazil is poor due to the lack of quality studies. Pharmacovigilance of OTC cough medications should be encouraged.O objetivo deste trabalho foi analisar o nível de evidências sobre a eficácia, a efetividade e a segurança dos medicamentos para tosse registrados no Brasil. A base de dados da Agência Nacional de Vigilância Sanitária foi empregada para identificar os medicamentos. Os ensaios clínicos, as revisões sistemáticas, as metanálises e os estudos de segurança foram pesquisados no Medline, the Cochrane Library e SIETES (Sistema de Informações Essenciais em Terapêutica e Saúde, base de dados em espanhol. A maioria dos medicamentos (62,5% eram comercializados como associação em dose fixa com dois ou mais fármacos. Ensaios clínicos randomizados foram encontrados apenas para três fármacos: bromexina, dextrometorfano e guaifenesina; para associações a dose fixa não foram encontrados ensaios clínicos. Revisões sistemáticas publicadas pela Cochrane n

  19. 小儿咳嗽的中医临床治疗效果观察%Clinical treatment of children with cough in traditional Chinese Medicine



    Objective To study and analyze the TCM clinical treatment of infantile cough.Methods From March 2014 to Augst 2015 in our hospital for treatment of 84 cases of chronic cough were included in the study, according to the different treatment of the 84 patients were divided into TCM treatment group (n=42) and Western Medicine group (n=42). The Chinese medicine treatment group, using traditional Chinese medicine therapy, drug selection of infantile Feirekechuan oral liquid for the treatment of Western medicine group, with Ambroxol Hydrochloride Oral Solution, Bromhexine Hydrochloride Tablets, Compound Codeine Phosphate Solution, Compound Pholcodine Oral Solution, budesonide, salbutamol sulfate aerosol (Wan Tuolin), Pediatric Paracetamol Atificial Cow-bezoar and Chlorphenamine Maleate Granules. Pediatric Pseudoephedrine Hydrochloride and Dextromethorphan Hydrobromide Drops and other treatment, compared two groups of children with cough, expectoration, changes in breathing.Results TCM treatment group in cough, sputum, wheezing, improve the situation, better than western medicine treatment group, the above data were significant difference (P < 0.05), the difference is statistically significant.Conclusion The author thinks that, for children with cough, symptomatic treatment can obtain ideal curative effect, in this regard, Chinese medicine treatment method is superior to the traditional western medicine therapy and the treatment measures worthy of a wide range of promotion and use in clinical.%目的:研究并分析小儿咳嗽的中医临床治疗方式。方法:将2014年3月~2015年8月在我院接受治疗的84例慢性咳嗽患儿纳入到本研究,按照治疗方式的不同将84例患儿分为中医治疗组(n=42)与西医治疗组(n=42),对于中医治疗组,采用中药疗法,药物选择小儿肺热咳喘口服液,对于西医治疗组,采用盐酸氨溴索口服液、盐酸溴已新片、复方磷酸可待因溶液、复