Study on mechanism of Qinbaohong Oral Liquid in anti-inflammation, stopping cough, eliminating phlegm and relieving asthma based on network pharmacology / 中国中药杂志

This study aimed to investigate the anti-inflammatory, antitussive, expectorant, and anti-asthmatic effects of Qinbaohong Oral Liquid in mouse experiments and explore its action mechanism based on network pharmacology. The mouse auricle swelling was induced by xylene for detecting the anti-inflammatory effect of Qinbaohong Oral Liquid, whose antitussive effect was then examined in mice with cough after exposure to ammonium hydroxide. The expectorant effect was determined based on the excretion of phenol red into the mouse trachea. The mouse model of asthma induced by histamine phosphate and acetylcholine chloride was used to observe the anti-asthmatic effect. The chemical components of Qinbaohong Oral Liquid were retrieved from TCMSP and literature, followed by target prediction based on BATMAN-TCM. The targets of inflammation, cough, expectoration, and asthma collected from GeneCards were intersected with drug targets for GO and KEGG enrichment analysis using Metascape. The results were imported into STRING for exploring protein-protein interactions and screening the key targets. As demonstrated by our findings, Qinbaohong Oral Liquid at 4.5 and 9.0 mL·kg~(-1) obviously decreased the weight(P<0.05) and thickness(P<0.01) of the right swelling ear and also the weight diffe-rence(swelling degree) between the two ears(P<0.05), prolonged the incubation period of cough(P<0.05), reduced the frequency of cough within 3 min(P<0.05), and increased the excretion of phenol red into the mouse trachea(P<0.01). Qinbaohong Oral Li-quid at 2.3, 4.5, and 9.0 mL·kg~(-1) dramatically prolonged the incubation period of asthma(P<0.05). A total of 324 chemical components and 1 245 targets were harvested for the Qinbaohong Oral Liquid, together with 10 272 inflammation targets, 4 400 cough targets, 192 expectoration targets, and 7 533 asthma targets. Their intersection revealed that the anti-inflammatory, antitussive, expectorant and anti-asthmatic effects of Qinbaohong Oral Liquid were correlated with such GO biological processes as the regulation of ion transport and blood circulation and such KEGG pathways as cancer-related signaling pathways and neuroactive ligand-receptor interaction. Qinbaohong Oral Liquid has been confirmed by both experiments and network pharmacology analysis to be efficient in anti-inflammation, stopping cough, eliminating phlegm, and relieving asthma.

Eficacia de la miel para el tratamiento de la tos aguda en niños atendidos en forma ambulatoria / Efficacy of honey for treatment of acute cough in pediatric outpatients

A partir de una consulta en la central de emergencias de un niño con tos aguda, el autor del artículo realiza una búsqueda bibliográfica para revisar la evidencia sobre el uso de la miel para aliviar este síntoma. Luego de la lectura crítica de una revisión sistemática, el autor concluye que ésta podría ser una alternativa elegible frente a los jarabes para la tos, por su perfil de seguridad y su posible beneficio en el alivio de la tos. (AU)

Based on a consultation at the emergency room of a child with acute cough, the author of this article performs a bibliographic search to review the evidence on the use of honey to alleviate this symptom. After the critical appraisal of a systematic review, the author concludes that honey could be an eligible alternative to cough syrups, due to its safety profile and its possible benefit in cough relief. (AU)

Review of Mesna (Mistabron) as a Mucolytic for Preventing Plumonary complications in Intensive Care Setting.

Impaired mucus clearance or mucus hypersecretion are important feature of many pathological respiratory conditions and in ICU patients. Mesna is a potent mucolytic available as 200 mg/ml solution for neublization and endotracheopulmonary instillation. As effective “mucus clearance” is critical in managing post-operative and other ICU conditions to prevent complications like atelectasis and hypoxia, there is a need to review the clinical results of mucolytic agent Mesna, and its role in mucociliary clearance in critical care patients and in other respiratory conditions.

A Randomized, Open Label, Multicentre Study to Evaluate the Safety and Efficacy of Cough Mixture CS1 (Pholcodeine and Promethazine - Tixylix) Versus CS2 (Noscapine, Ammonium Chloride, Sodium Citrate) in Treatment of Children with Dry Cough.

The objective of this study was to compare the efficacy and safety of cough mixture containing pholcodeine and promethazine - Tixylix (CS1) to a cough mixture which has noscapine, ammonium chloride, and sodium citrate (CS2) as its constituents in treatment of children suffering from dry cough. A total of 208 patients were enrolled at 4 sites. Of these, 179 (94 receiving CS1 and 99 receiving CS2) completed the study. Results of this study suggest that both the cough mixtures were comparable as per evaluation of their primary parameters. According to global assessment for efficacy and tolerability by parents on Day 7, Group CS1 performed better than CS2. It was also observed that no AE was reported in Group CS1 as compared to 2 AEs in Group CS2. To conclude, cough mixture combination of pholcodeine and promethazine - Tixylix exhibited efficacy and safety that was comparable with cough mixture which has noscapine, ammonium chloride, and sodium citrate. It was proven to be efficacious, safe and well tolerated in the select population.

Tosse: neurofisiologia, métodos de pesquisa, terapia farmacológica e fonoaudiológica / Cough: neurophysiology, methods of research, pharmacological therapy and phonoaudiology

Introdução: A tosse é o sintoma respiratório mais comum em crianças e adultos. Objetivo: Apresentar uma revisão sobre a neurofisiologia e os métodos para estudo do reflexo da tosse, bem como a farmacoterapia e terapia fonoaudiológica da tosse, baseada nos trabalhos publicados entre 2005 e 2010 e indexados nas bases Medline, Lilacs e Biblioteca Cochrane sob os unitermos "tosse" ou "antitussígenos". Síntese dos dados: O reflexo da tosse envolve ativação de múltiplos receptores vagais nas vias aéreas e de projeções neurais do núcleo do trato solitário para outras estruturas do sistema nervoso central. Técnicas experimentais permitem estudar o reflexo da tosse ao nível celular e molecular para desenvolver novos agentes antitussígenos. Não há evidências de que antitussígenos isentos de prescrição médica tenham eficácia superior à do placebo para o alívio da tosse. A terapia fonoaudiológica pode beneficiar pacientes com tosse crônica refratária ao tratamento farmacológico, sobretudo quando coexiste movimento paradoxal das pregas vocais. Comentários Finais: A abordagem multidisciplinar tem papel fundamental no diagnóstico etiológico e tratamento da tosse. O otorrinolaringologista deve informar os pacientes sobre os riscos dos antitussígenos de venda livre a fim de prevenir intoxicações e efeitos adversos, especialmente em crianças...

Introduction: The cough is the more common respiratory symptom in children and adults. Objective: To present a revision on the neurophysiology and the methods for study of the consequence of the cough, as well as the pharmacotherapy and phonoaudiology therapy of the cough, based on the works published between 2005 and 2010 and indexed in the bases Medline, Lilacs and Library Cochrane under them to keywords "cough" or "anti-cough". Synthesis of the data: The consequence of the cough involves activation of receiving multiples becomes vacant in the aerial ways and of neural projections of the nucleus of the solitary treatment for other structures of the central nervous system. Experimental techniques allow studying the consequence of the cough to the cellular and molecular level to develop new anti-cough agents. It does not have evidences of that anti-cough exempt of medical lapsing they have superior effectiveness to the one of placebo for the relief of the cough. The phonoaudiology therapy can benefit patients with refractory chronic cough to the pharmacological treatment, over all when paradoxical movement of the vocal folds coexists. Final Comments: The boarding to multidiscipline has basic paper in the etiological diagnosis and treatment of the cough. The otolaryngologist must inform the patients on the risks of the anti-cough of free sales in order to prevent adverse poisonings and effect, especially in children...

Eficácia antitussígena de duas formulações fitoterápicas / Antitussive efficacy of two phytotherapics formulations

Avaliaram-se os efeitos antitussígenos-expectorantes de duas formulações fitoterápicas utilizando-se três modelos biológicos diferentes. Foram utilizados ratos Wistar no modelo da secreção das vias aéreas, cobaias no modelo de tosse induzido por ácido cítrico e codornas japonesas na determinação da velocidade de transporte mucociliar. Os animais foram distribuídos em grupos e tratados por via oral com as formulações, com doses equivalentes a 10 vezes a terapêutica recomendada, 9ml.kg-1. O grupo-controle negativo de cada espécie foi tratado com solução fisiológica, 10ml.kg-1. O grupo-controle positivo no modelo de tosse induzida pelo ácido cítrico foi tratado com morfina, 1mg.kg-1, por via subcutânea. No modelo em que foram utilizados ratos e codornas, o grupo-controle positivo recebeu erdosteína por via oral, 600mg.kg-1. Os resultados mostraram que as duas formulações fitoterápicas foram eficazes no reflexo da tosse em cobaias, causando 36,4 por cento e 27,3 por cento, respectivamente, de redução. Nos modelos de secreção das vias aéreas e determinação da velocidade de transporte mucociliar, ambas as formulações não apresentaram eficácia significativa.

The antitussive-expectorant effects of two phytotherapic formulations available in the Brazilian market were evaluated using three different biological models. Each phytotherapic formulation, with different composition, had the same batch number and fabrication date. The trade names of the phytotherapics were: Gripalplus Solução® and Melagrião®. Wistar rats were used in the airway secretion model, guinea pigs in the citric acid-induced cough model and japanese quails in the mucociliary transport rate determination. The animals (one group/formulation) were divided in the two phytotherapic groups and orally treated with the equivalent to ten told the therapeutic recommended dose, which was 9ml.kg-1. Animals of negative control group of each specie were orally treated with 10ml.kg-1 of saline. Positive guinea-pigs citric acid-induced cough model was subcutaneously treated with 1mg.kg-1 of morphine. In the rats airway secretion model and japanese quails mucociliary transport rate, a positive control orally received 600mg.kg-1 of erdosteine. The results showed that both phytotherapic formulations were able to inhibit the guinea pig cough reflex induced by citric acid, being 36.4 percent of reduction in the Gripalplus Solução® group and 27.3 percent in the Melagrião® group. The rats airway secretion and the mucociliary transport rate were not significantly affected by the two phytotherapic formulations.

Pharmacological control of cough.

Cough constitutes an important medical problem in all ages. Although treatment of underlying pathologies, e.g., bronchial asthma, upper respiratory tract infection, etc. is well justified to cure cough, non-specific therapy in the form of a number of antitussive agents like, codeine, dextromethorphan, etc. is widely practiced to suppress it. Most of these agents are efficacious and well-tolerated. Nevertheless, CNS toxicities may occur in new-borns, especially those with immature metabolic profile. Some recent reports about interactions (involving hepatic cytochrome P450 enzymes) between dextromethorphan and other drugs are also noteworthy.

Pharmacy distribution of advice, symptomatic treatment and antimicrobial drugs to patients with cough

It i an accepted fact that, in many countries, pharmacies are the predominat source of medical advice over-the-counter drugs, and supplies of "prescription-only" drugs for sale without a prescription. To assess the activities conducted by pharmacists or pharmacy counter assistants in response to a common health problem, a cross-sectional study was done at 114 pharmacies in Porto Alegre, Brazil. A fictitious case-history of cough was used by trained personnel entering the pharmacy and the subsequent activities by the pharmacist or pharmacy counter assistant were analyzed. Some kind of medication was provided in 101 (88.5 percent)of the pharmacies. Pharmacists gave medication in 80 percent of pharmacies, and pharmacy assistants in 95.5 percent (p<0.03). The class of medication most frequently dispensed was the expectorants (97 times, 92.4 percent), however, systemic antibiotics were provided in 11 pharmacies (10.5 percent). Of note, the pharmacists provided antibiotics more frequently than did pharmacy assistants (p=0.016). We conclude that pharmacy advice and symptomatic medical care (expectorants) are very common and that pharmacy assistants are more likely than pharmacists to provide medication. Of concern, when pharmacists were the drug dispensers of antibiotics which should be provided by prescription only, drugs were provided without proper diagnosis, and often incorrect dosages. This reflects a pontentially dangerous practice in need of careful evaluation, education and supervision.

Diseño y aplicabilidad de una guía clínica para la atención apropiada en las infecciones respiratorias agudas / Desing and applicability of a clinical guide for appropriate attention in acute respiratory infections

Las guías clínicas son un auxilio en la decisión del médico para la atención apropiada del paciente. Se diseñó una guía clínica dirigida a los médicos del primer nivel de atención, que integra la prevención, el diagnóstico y el tratamiento de las infecciones, el diagnóstico y el tratamiento de las infecciones respiratorias agudas. Metodología. El desarrollo de la guía se realizó en dos fases: 1) La de construcción, que incluyó las siguientes etapas; definición de los problemas a resolver, definición del usuario y de los servicios de salud, revisión bibiográfica, desarrollo conceptual, desarrollo de la estructura, validación de constructo y validación de contenido por el método Delfos. 2) La implementación de la guía. Se evaluó la aplicabilidad de la guía en 115 pacientes de 20 médicos, a través de la concordancia (Kappa no ponderada) entre los diagnósticos médicos y los criterios de la guía clínica. Se midieron las diferencia en la atención de los enfermos con y sin la utilización de las guías (X² o Fisher). Resultados. Se construyó una guía para niños menores de cinco años y otra para personas mayores. La aplicación de la guía se elevó de 40 a 60 por ciento, así mismo, disminuyó la indicación de antitusígenos y de antibióticos con aumento de su indicación justificada. Conclusiones. La guía propuesta reune características para ser una herramienta auxiliar aplicable en la atención de las infecciones respiratorias agudas. Deberá evaluarse su eficacia para mejorar el diagnóstico y la prescripción médica

Medicamentos utilizados em criancas para tratamento do resfriado comum: risco vs. beneficios / Medications used in children for cold treatment: risks vs benefits

A autora apresenta uma revisao sobre a eficacia e efeitos adversos dos medicamentos utilizados no tratamento da rinofaringite aguda da crianca.

Farmacos do aparelho respiratorio / Respiratory tract drugs

Revisao sucinta de farmacos utilizados no tratamento de doencas que acometem o aparelho respiratorio,a saber:antitussigenos,expectorantes,farmacos para o resfriado comum,antiasmaticos e tensoativos pulmonares.

Tos persistente en el niño / Chronic caugh in children

En el presente trabajo el autor hace referencia a la tos en general, y a la tos persistente en particular, aquella que tiene una duración de 3 o más semanas es decir la tos crónica. Señalando esta patología como un importante problema, no solamente para los niños sino tambien para los adultos. Las recomendaciones, sobre el tratamiento usando agentes antitusígenos

Tratamiento racional de la tos / Rational treatment of cough

La tos normal, definida en la forma más simple, es una espiración explosiva. Después de una corta inspiración se cierra la glotis y se ocluye, en forma parcial o total, la región naso-faríngea por el paladar blando; se genera así un poderoso esfuerzo expiratorio de los músculos abdominales y torácicos, cuya presión comprime las vías aéreas reduciendo alrededor del 40%de su diámetro inspiratorio. Esta estrechez es ventajosa, ya que al aumentar la velocidad del flujo aéreo facilita la expulsión de secreciones o material extraño. Cuando la tos es infrecuente y no repetitiva, puede considerarse como normal o fisiológica al eliminar las secreciones que forman parte de un proceso natural. Cuando la tos es intensa, repetitiva e incontrolable y especialmente cuando es seca o poco húmeda, debe considerarse anormal, y potencialmente dañina. En general el enfoque terapéutico se dirije a la fluidificación de las secreciones bronquiales o a evitar o suprimir la sensibilidad de los sitios de origen de los impulsos aparentes de la tos. Este enfoque requiere de un exacto conocimiento de la o las causas de la tos en cada individuo