All vent syrup
Bronchodilator, Mucolytic ,Expectorant & Demuicent
Sugar & Dye free with the natural taste of menthol
Composition:
Each 5 ml of All vent syrup contains:
– Bromhexine hydrochloride 4 mg
– Terbutaline sulphate 1.25 mg
– Guaifenesin 50 mg
-Menthol 2.5 mg
Properties:
syrup has the advantage of combining four active Ingredients namely; Bromhexine hydrochloride, (mucolytic), Guaifenesin (expectorant), Terbutaline sulphate (bronchodiator) in addition to menthol that otfers a great cooling sensation in a specially formulated vehicle that gives the final preparation the advantages of being sugar free, dye free and naturally menthol fIavored. This widens the scope of its application to allergic asthmatic type patients as well as diabetics. Mechanisms of action of the four Ingredients are as follows :
Bromhexlne hydrochloride : is a mucolytic agent, which liquifies !hide, tenacious sputum. Viscosity of sputum is reduced by dissolving mucopolysaccharide fibers. ” also improves mucociliary dearanc:e of secretions.
Guaifenesin : is an expectOOlnl 11 increases the output of sputum and bronchial secretions by reducing adhesiveness and surface tension. By increasing the volume of bronchial secretions, it reduces the vtscosity of leoacious sputum. The increased flow of less viscid
secretions also promotes ciliary action.
Terbutaline sulphate : is a diredty acting sympathomimetic agent with selective Jl2- stimulant effect. fi2-agoinsts help alleviate
bronchospasm associated with cough, relief bronchospasm. and facilitates drainage of accumulated secretions.
Menthol: acts as a demulcent and soothing agent
Pharmacokinetics :
Bromhexlne hydrochloride is rapidly absorbed from the gastroinlestinal tract and about 85 to 90 % of the dose Is excreted in
the urine, mainly as metaboIites. One of these ambroxol is a phannacclogically active. actions similar to the parent compound.
Bromhexine hydrochloride is highly bound to plasma proteins.
Gualfenuln is absorbed from the gastrointestinal tract. It is metabolized and excreted in the urine. rerbutaline sulphate Is variably absorbed from the gastrointestinal tract and is subjected
to fairly extensive first pass metabolism. There are no known active melabolites. Terbutaline has hart life of J..4 hours. It is excreted In the urine partly as inactive conjugates and partly as unchanged
Indications:
All vent syrup is Indicated in the treatment of productive cough when associated with bronchospasm In conditions such as :
– Bronchitis and bronchial asthma.
– Chronic obstructive pulmonary disease (COPD).
– Bronchiectasis.
– Emphysema.
Dosage and administration:
All vent is usually given 3 times a day in the following doses :
– Adults : 2 teaspoonfuls (10 ml).
– Children :
– (6-12 yea rs ): 1 teaspoonful (5 ml)
– (2.£ yea rs ): 112 teaspoonful (2.5 ml)
Side effects :
The most commonly observed side effects are tremor and nervousness. The frequency of these side effects appear to diminish with continued therapy. a Other commonly reported reactions Include lnaeased heart rate, palpitations. dizziness, headache, drowsiness, vomiling, nausea, sweating and muscle cramps . These raactions are generally transient and usually do not require treatment.
Bromhexfne : gastrointestinal side effects may occur occasionally with bromhexine and a transient rise in serum aminotransferase
values has been reported.
Guaifenesin : gastroinlestinal discomfort has occasionally been reported with guaifenesin. Very large doses cause nausea and vomiting.
Terbutallne : the adverse reactions of terbutaline sulphate are aimitar to those of other sympathomimetic agents.
Warning and precautions:
While treating cough as a symptom. it is important to make every effort to determine and treat appropriately the underlying cause,
such as a specific infedion. Caution should be ccseved prescriJing
to patients with hypertension, disease anhythmias. coronary insufficiency) uncontrolled diabetes mellitus and patients with hyperthyroidism, Patients susceptible to hypokalemia should be monitored because transient early falls In serum potassium levels have been reported Since mucolytics, such as bromhexioe. may
disrupt the gastric mucosal barrier, Bromhexlne should be used with care in patients with a history of peptic ulceration .
This product is contraindicated in children less than 2 years .
This product cannot be used for children less than 6 years unless medical supervision.
Pregnancy and lactation:
Safety of All vent has not been studied in pregnant and lactating women Therefore, probable benefits should be weighed aga;ns!
possible risks before prescribing All vent during pregnancy and lactation.
Contraindications :
This medication is contraindicated for patients with a history of hypersensitivity to sympathetic amines and any other components in the preparation.
Drug interactions:
– Adverse metabolic effects of high dose agonist such as terbutaline may be exacerbated by concomitant administration of high doses of corticosteroids.
– Hypokalemia with high doses of agonists may results in increased susceptibility to digitalis induced cardiac arrhythmias Hypokalemia may be enhanced by concomitant administration of aminophylline or other xanthines, corticosteroids or by diuretic therapy.
– Terbutaline reduces serum theophylline concentrations by increasing its systemic clearance. This may Of may not have dinical
implications as improved clinical scores have still occured with combined therapy despite the theophylline concentrations being lower than when used alone. If respiratory symptoms persist, an increase in dosage may be contemplated while monitoring theophylline aide-effects and concentration.
– Other sympathomimetic bronchodilators or epinephline should not be used concomitantly with terbutaline sulphate since their combined effect on cardiovascular system may be deleterious to the patient. This rerommendation does not preclude the Judtcious use of an aerosol bronchodilator of the adrenergic stimulant type in patients receiving
– Terbutaline sulphate should be administered with caution in patients being treated with MAO Inhibitors (as Furazolidone) or tricydic antidepressants, since the action of tetbutallna sulphate 00 the vascular system may be potentlated.
– B2-adrenergfc receptor blocking agents not only block the pulmonary effect of terbutaJine but may produce severe asthmatic attacks in asthmatic patients. Therefore, patients requiring treatment for both bronchospastic disease and hypertenskln should be treated with medication other than p-adrenergic blocking agents for hypertension.
Storage and presentation:
– Bottle of 125 rnl.
– Store away from light at a temperature not exceeding 30°C.
– Keep all medicaments out 01 roach 01 children
Produced by :
BORG PHARMACEUTICAL INO.
Borg El-Arab new city Alexandria – Egypt
