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.

Influence of histamine and H1-receptor antagonists on ejaculated human spermatozoa: role of intrasperm Ca2+.

Histamine reduced sperm viability in a dose- and time-dependent manner, accompanied by rise in intrasperm Ca2+. Further, 2',4'-dichlorobenzamil hydrochloride (DBZ), a Na+-Ca2+ exchange inhibitor, known to elevate intrasperm Ca2+, potentiated both, elevation of intrasperm Ca2+ and spermicidal action of histamine. Pretreatment of sperm with very low doses of H1-receptor antagonists (chlorpheniramine, promethazine or diphenhydramine) prevented the histamine-induced elevation of intrasperm Ca2+ as well as its spermicidal action. However, pretreatment with famotidine, a H2-receptor antagonist did not produce such a protective action. The results strongly suggest that histamine elicits its spermicidal action via H1-receptors present on sperm cells.

[ effect of Atropine, Hyoscine and Promethazine on the duration of labour stages and rate of labour progress in multiparous women]

In most cases, labour is accompanied with pain. Thus, decreasing labour pain is viewed as an important duty of midwives. In this regard, decreasing the duration of labour can be of value. Customarily midwives use drugs to shorten the duration of labour, but the effectiveness of some of the drugs has not been studied systematically. Among such widely used drugs are Atropine, Hyoscine and Promethazine. In this interventional research, the effects of these drugs on labour duration were studied. 160 multiparous women in active phase of labour were selected. 120 of the above women had been administered only one of the above-mentioned drugs and no drug had been administered to the remaining 40. According to the type of drug administered, the women formed three groups, with the women with no drugs administered making the fourth groups. The four groups did not have any statistically significant difference with regard to variables such as age, occupation, education, infant sex, gestational age, infant birth weight, parity, fetal head position, and cervical dilatation at the beginning of our observation. The main result was that, the mean rate of cervical effacement [P<0.05] and descent of fetal head was not significantly different in the 4 groups. But the mean rate of cervical dilatation [P<0.05] was significantly different in four groups. In women who had been given these drugs, the mean rate of cervical dilatation was lower than the women who had not been given any drugs. The mean duration of the first stage of labour was significantly different in four groups [P<0.05]. With regard to the mean duration of the first stage of labour, it was also longer in women who had been given these drugs. The mean rate of second stage of labour and third stage of labour was not significantly different in 4 groups. The use of these drugs can reduce the rate of labour progress and increase the risk of complications, it may also be a waste of prescribed drugs

Effect of pre-medication on arterial oxygen saturation in patients undergoing coronary artery bypass sugery

We studied 50 patients scheduled for coronary artery bypass surgery at Armed Forces Institute of Cardiology/ National Institute of Heart Diseases, Rawalpindi, following premedication with lorazepam, morphine and promethazine using pulse oximetry readings. Arterial oxygen saturation [SPO2] values were obtained a night before operation and compared with those values obtained after premedication administration. Twenty two of the 50 patients developed significant hypoxemia which was readily corrected by administration of supplementry oxygen in the operating theatre. It is concluded that significant oxygen de-saturation occurs after opioid plus sedative premedication in coronary artery bypass surgery patients. As a result of our findings we urge caution in the use of opioid plus sedative premedication and recommend that oximetry monitoring and oxygen supplement be considered after premedication of these patients

Effects of diazepam and promethazine on uterine contractions induced by prostaglandin E2 [PGE2]

This study was conducted at Basic Medical Sciences Institute, Jinnah Post Graduate Medical Center, Karachi. It was done to observe the inhibitory effects of diazepam and promethazine, on uterine contractions induced by prostaglandin E2 [PGE.2]. The drug interaction, in vitro, proved that both diazepam and promethazine are tocolytic in vitro

Conscious sedation for pediatric cardiac catheterization

Diagnostic procedures make up a major portion of the practice of pediatric cardiology. Patient cooperation, often for extended periods, is of utmost importance for successful complication of many pediatric cardiac diagnostic procedures particularly those involving infants and preschool-age children. This requires the use of sedation. Invasive procedures such as cardiac catheterization and transesophageal echocardiography may cause significant discomfort, necessitating the use of additional analgesic and amnesic agents. Multiple drugs or repeated dose may be required during lengthy procedures. Ensuring patient safety by appropriate cardiorespiratory monitoring is mandatory. This review focuses on the pharmacologic agents used in pediatric cardiac catheterization. The pharmacology, indications for usage, and the risks and benefits of commonly used agents are addressed

Trypanocidal effects of promethazine

Promethazine is currently used for its antipsychotic and ansiolytic effects. It is a phenothiazine with anticalmodulin action, not toxic for human beings at therapeutic dosis. The present results show that promethazine has trypanocidal effect on both epimastigote and trypomastigote stages of T. cruzi; two hundred muM inhibited epimastigote growth in culture medium and 2 muM immobilized and killed bloodstream trypomastigotes. When promethazine (55 mg/Kg/day) was used as treatment of T. cruzi infected mice, it proved effective in reducing parasitemia and it increased the survival of treated animals. Ultrastructural studies suggest that the lethal effect of this phenothiazine is related to a detergent effect that disrupts T. cruzi cell membrane.

Use of sedation analgesia for pediatric dentistry.

26 healthy children between the ages of 36 and 60 months (mean 35 months) who satisfied the selection criteria during a screening visit participated in this double blind study. The subjects were assigned randomly to receive either 75 mg/kg Triclofos elixir (Regimen I-21 children) or 50 mg/1kg Trichlofos elixir combined with 1 mg/kg promethazine elixir (Regimen II-22 children). All medications were given orally 45 minutes before treatment. During operative procedures all subjects received nitrous oxide/oxygen at a concentration of 35%. All the patients were restrained in a papoose board (Indigenous). The subjects were monitored for vital signs and evaluated for sedation and sleep, movement, crying and overall behaviour before, during and after the operative procedure. Regimen II was found to be superior to Regimen I with regard to behaviour management of difficult young children. However extremely apprehensive children were not good subjects for this sedation technique.

Effects of antihistamines on wound healing.

Role of antihistamines (H1 and H2 blockers) in wound healing by utilizing incision and dead space wound models in albino rats was investigated. H1 blockers (mepyramine and promethazine) were found to decrease breaking strength of 10 day old dermal incision wounds and collagen content (as hydroxyproline) and breaking strength of granulation tissue harvested over tubular implant. On the other hand H2 blockers (Cimetidine and ranitidine) did not alter the above parameters. The findings that H1 blockers suppress healing implicate H1 receptors in alleged prohealing effect of histamine, and suggest clinical evaluation of these agents for suppression of overhealing states like keloid, adhesions and strictures.

Modification of radiation induced lipid peroxidation by calmodulin antagonists.

It has been shown that calmodulin antagonists provide radio-protection in euoxic and sensitization in hypoxic conditions. This differential protection in euoxic conditions might have arisen from the interaction of calmodulin antagonists with oxygen free radicals. This possibility has been tested in the present communication. Radiation induced lipid peroxidation process in liposomes has been used for this purpose. Liposomes prepared from L-alpha-lecithin were irradiated with or without calmodulin antagonists. Calmodulin antagonists inhibited lipid peroxidation significantly. The inhibition was found to increase with increase in concentration of the drugs. These observations suggest that calmodulin antagonists have a capacity to scavenge oxygen free radicals involved in initiation and/or propagation of lipid peroxidation process. This may be the reason for their differential radioprotection in euoxic conditions in biological systems.

Drug interaction of promethazine & other non-conventional antimicrobial chemotherapeutic agents.

The antihistamine compound promethazine (Pz) showed significant antibacterial action when tested against 124 strains of aerobic and 13 strains of anaerobic bacteria belonging to both Gram positive and Gram negative genera. The range of MIC (micrograms/ml) of Pz varied between 50 and 200 micrograms/ml among most of the test organisms. Six Pz-sensitive strains were found to be simultaneously sensitive to similar non-conventional antimicrobics, e.g., methdilazine, bromodiphenhydramine, diphenhydramine, methyl-DOPA, promazine and the antibiotic augmentin. A high degree of synergism was observed in vitro when Pz was used in combination with methdilazine and bromodiphenhydramine.