Expectorant and Antitussive Effect of Hedera helix and Rhizoma coptidis Extracts Mixture

PURPOSE: This study aims to investigate the additive effect of the Hedera helix (HH) and Rhizoma coptidis (RC) extracts mixture on antitussive and expectorant activities in animals. MATERIALS AND METHODS: The expectorant assay was performed with phenol red secretion in mice trachea. Mice or guinea pigs were randomly divided into groups of 8 each, including negative and positive control groups. After gastric administration of the test extracts in mice, 2.5% phenol red solution (0.2 mL) was intraperitoneally injected. Trachea was dissected and optical density of tracheal secretion was measured. After gastric administration of the test extracts in guinea pigs, the antitussive activities were assessed using a citric acid-induced cough measurement. RESULTS: The extracts of HH and RC significantly increased tracheal secretion and inhibited cough. The mixture of HH and RC extracts in a 1:1 concentration at a dose of 200 mg/kg showed a more potent effect on phenol red secretion (25.25+/-3.14) and cough inhibition (61.25+/-5.36) than the individual use of each extracts [phenol red secretion; HH 13.39+/-4.22 (p=0.000), RC 20.78+/-2.50 (p=0.010), cough inhibition; HH 9.89+/-4.14 (p=0.010), RC 30.25+/-7.69 (p=0.000)]. A 3:1 ratio mixture of HH to RC demonstrated an optimal expectorant effect (p<0.001), and this mixture showed expectorant and antitussive effects in a dose-dependent manner. CONCLUSION: This study provides evidence for antitussive and expectorant effect of a 3:1 mixture of HH and RC, which may be a useful therapeutic option for respiratory diseases.

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.

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.

Efficacy and safety of Ascoril expectorant and other cough formula in the treatment of cough management in paediatric and adult patients--a randomised double-blind comparative trial.

The present study was undertaken to study the comparative safety and efficacy of two cough formulas viz, Ascoril expectorant and other cough formula in the management of cough associated with respiratory disorders. Fifty patients having cough associated with various respiratory disorders like bronchitis and upper or lower respiratory tract infections were randomly divided into 2 equal groups and were treated with one of the two cough formulas viz, Ascoril cough formula and other cough formula in double-blind manner over a period of 15 days. The evaluation of improvement was carried out by a rating scale using three clinical parameters--cough, sputum and breathlessness. The physicians were asked to rate the effectiveness of the therapy and patients were asked to rate the acceptability of therapy using pre-defined operational criteria. It was observed that the improvement and symptom relief was almost immediate, quicker and better in the group receiving Ascoril as compared to other group. On effectiveness parameter, 96% of the physicians rated Ascoril as having either 'very high effectiveness or high effectiveness' as opposed to only 34% of the physicians who rated other cough formula as having 'high' or 'very high effectiveness'. While on parameter of acceptability, 96% of the patients rated acceptability of Ascoril as 'high' or 'good' as opposed to only 24% of the patients who rated other cough formula 'high' or 'good'. The findings of this study suggests that Ascoril cough formula has better efficacy as well as better patient acceptability. Thus, Ascoril cough formula is superior to other cough formula in management of cough associated with respiratory disorders.

Amoxicilina/erdosteína en el tratamiento de bronquitis. Estudio pediátrico controlado / Amoxicilin/erdosteine in bronchitis treatment. Controlled pediatric case

La bronquitis es definida como una reacción de defensa del árbol respiratorio bronquial que ocasiona tos como síntoma fundamental además de otros que la acompañan. La amoxicilina ha demostrado su eficacia para controlar la infección bacteriana. En el tratamiento se han añadido sustancias mucolíticas que ayudan a fluidificar las secreciones, disminuir su adhesividad, viscosidad y cantidad y por tanto facilitar la expulsión. En el presente estudio se seleccionan 64 pacientes de ambos sexos y con edades de 2 a 12 años con el diagnóstico de bronquitis divididos en dos grupos. El grupo A está formado por 31 pacientes y se les da amoxicilina/erdosteína a 50 mg/kg/día y 10 mg/kg/día, respectivamente. Al grupo B sólo se le dio amoxicilina a 50 mg/kg/día. En ambos grupos el tratamiento se prolongó por 10 días. Se realizó evaluación clínica y radiológica al inicio del estudio y al décimo día, al décimo quinto día se realizó una última evaluación clínica.Se encontró que la combinación amoxicilina/erdosteína es más eficaz que amoxicilina sola, mejorando los resultados en cuanto a la odinofagia, estertores bronquiales, tos húmeda matinal y vespertina. Con respecto a fiebre, hiporexia, astenia, cefalea, polipnea y sibilancias, la combinación no demostró superioridad con respecto al uso de amoxicilina sola

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.