Salbutamol + Etofylline + Bromhexine

Indications

Salbutamol + Etofylline + Bromhexine is used for: Bronchial asthma, chronic asthmatic bronchitis, emphysema, COPD & as an adjunct to antibacterials in respiratory infections associated with bronchospasm.

Adult Dose

Oral Adult 1-2 tabs tid-qid

Child Dose

Renal Dose

Administration

Contra Indications

Hypersensitivity

Precautions

Hyperthyroidism, myocardial insufficiency, arrhythmias, susceptibility to QT-interval prolongation, HTN, DM, glaucoma, hypokalaemia, seizure disorder. Renal impairment. Elderly. Pregnancy and lactation. Monitoring Parameters Monitor BP, heart rate, electrolyte and fluid balance; glucose, lactate and K levels.

Pregnancy-Lactation

Interactions

Adverse Effects

Side effects of Salbutamol + Etofylline + Bromhexine : Tremor, nervousness, nausea and vomiting, tachycardia, palpitations, chest pain, shakiness, dizziness, headache, insomnia, inhalation site sensation, hyperactivity, HTN, hypotension, increased sweating, allergic reactions, DM, muscle cramps, flu-like syndrome, conjunctivitis, UTI, hypokalaemia,. Rarely, erythema multiforme, Stevens-Johnson syndrome. Potentially Fatal: Paradoxical bronchospasm.

Mechanism of Action

Salbutamol activates adenyl cyclase, the enzyme that stimulates the production of cyclic adenosine-3', 5'-monophosphate (cAMP). Increased cAMP leads to activation of protein kinase A, which inhibits phosphorylation of myosin and lowers intracellular ionic Ca concentrations, resulting in smooth muscle relaxation. Bromhexine enhances mucus transport by reducing mucus viscosity and by activating the ciliated epithelium (mucociliary clearance). This secretolytic and secretomotor effect in the bronchial tract area relieves cough and facilitates expectoration.