Codeine + Sodium bicarbonate + Terpin hydrate (Codeinum + Natrii hydrocarbonas + Therpinhydratum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Antitussives

Included in the formulation
  • Terpincode®
    pills inwards 
    PHARMSTANDART-FORESTRY, OJSC     Russia
    • АТХ:

    R.05.F.A.02   Opium derivatives in combination with expectorants

    Pharmacodynamics:

    The opioid activity of codeine is due to the transformation into morphine. Weak agonist opioidnyh λ- and φ-receptors (activation of λ-receptors is 3 times stronger than φ): suppression of interneuronal transmission of painful impulses in the afferent ways of the central nervous system, a decrease in the emotional evaluation of pain and reaction to it, pronounced antitussive activity.

    Sodium bicarbonate - oreflex action reflex. Irritating effect on mucosal receptors stomach, reflexively increase the secretion of the bronchial glands and the mobility of the ciliated epithelium. As a result of an increase in the amount of secretion, sputum becomes more fluid, less viscous and adhesive. Increased activity of ciliated epithelium and peristaltic movements of bronchioles promotes sputum from the lower in the upper respiratory tract and its excretion.

    Sodium bicarbonate shifts the pH of the bronchial mucus to the alkaline side, reduces the viscosity of the sputum, to some extent also stimulates the motor function of the ciliated epithelium and bronchioles.Promotes the removal of mucus from the respiratory tract with cough and weakens the cough reflex.

    Terpinhydrate is a synthetic expectorant of reflex action - para-mentan-diol-1,8-hydrate, enhances the secretion of bronchial glands, has an expectorant effect.

    Pharmacokinetics:

    The components of the drug are well absorbed into the digestive tract.

    Codeine slightly binds to plasma proteins. It is subject to biotransformation in the liver (10% by demethylation passes into morphine). It is excreted by the kidneys (5-15% - unchanged).

    Pharmacokinetics terpinhydrate is not studied.

    Sodium bicarbonate is eliminated by the kidneys formed CO2 - the lungs.

    Indications:

    Cough of various genesis, accompanied by difficulty in separating the sputum.

    ICD-10

    XVIII.R00-R09.R05   Cough

    X.J60-J70.J68.0   Bronchitis and pneumonitis caused by chemicals, gases, fumes and vapors

    X.J40-J47.J42   Chronic bronchitis, unspecified

    X.J40-J47.J41.8   Mixed, simple and mucopurulent chronic bronchitis

    X.J40-J47.J41.1   Muco-purulent chronic bronchitis

    X.J40-J47.J41.0   Simple chronic bronchitis

    X.J40-J47.J41   Simple and muco-purulent chronic bronchitis

    X.J40-J47.J40   Bronchitis, not specified as acute or chronic

    X.J20-J22.J20.9   Acute bronchitis, unspecified

    X.J20-J22.J20.8   Acute bronchitis caused by other specified agents

    X.J20-J22.J20.7   Acute bronchitis caused by echovirus

    X.J20-J22.J20.6   Acute bronchitis caused by rhinovirus

    X.J20-J22.J20.5   Acute bronchitis caused by respiratory syncytial virus

    X.J20-J22.J20.4   Acute bronchitis caused by parainfluenza virus

    X.J20-J22.J20.3   Acute bronchitis caused by the Coxsackie virus

    X.J20-J22.J20.2   Acute bronchitis caused by streptococcus

    X.J20-J22.J20.1   Acute bronchitis caused by Haemophilus influenzae [Afanasyev-Pfeiffer's]

    X.J20-J22.J20.0   Acute bronchitis caused by Mycoplasma pneumoniae

    X.J20-J22.J20   Acute bronchitis

    Contraindications:

    Hypersensitivity to the components of the drug, respiratory failure, bronchial asthma, simultaneous intake of ethanol or narcotic analgesics, children's age (up to 2 years), pregnancy and lactation.

    Carefully:

    Children under 12 years.

    Pregnancy and lactation:

    The category of FDA recommendations is not defined.

    Contraindicated in pregnancy, during lactation.

    Dosing and Administration:

    Inside, 1 tablet 2-3 times a day.

    The maximum single dose of codeine is 50 mg. The maximum daily dose of codeine is 200 mg. The recommended duration of therapy is 3 to 5 days.Patients with reduced renal function may need a dose adjustment.

    Side effects:

    Allergic reaction (itching, hives). Nausea, vomiting, constipation, headache, drowsiness.

    With prolonged use - the development of drug dependence to codeine.

    Overdose:

    Symptoms: vomiting, drowsiness, atony of the bladder, impaired coordination of eyeball movements with visual impairment, bradypnoe, respiratory center depression, arrhythmias, bradycardia.

    Treatment: gastric lavage with activated charcoal, potassium permanganate, the introduction of respiratory analeptics, atropine and a competitive physiological codeine-naloxone antagonist.

    Interaction:

    Chloramphenicol inhibits the metabolism of codeine in the liver and thereby enhances its effect.

    With the simultaneous use of drugs, depressing the central nervous system (including hypnotics, antihistamines, antipsychotic drugs, narcotic analgesics), it is possible to increase the sedative effect and depressant effect on the respiratory center.

    When using codeine in large doses, the action of cardiac glycosides (digoxin and others) can be amplified, because in connection with the weakening of peristalsis, their absorption increases.

    Adsorbents, astringent and enveloping medicines can reduce the absorption of codeine.

    Special instructions:

    It is possible to reduce the concentration and speed of psychomotor reactions, therefore, during the treatment period, care should be taken when driving vehicles and engaging in other potentially dangerous activities that require an increased concentration of attention and speed of psychomotor reactions.

    Can influence the results of doping control.

    With prolonged, uncontrolled use, it is possible to develop addiction (weakening analgesic effect) and drug dependence.

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