Xanthines: Xanthines, primarily theophylline, relieve bronchial spasm by direct action on the bronchial smooth muscle in bronchospastic conditions such as asthma and chronic bronchitis. Some xanthine-containing combination products are available over-the-counter, but asthmatic patients should use them only under physician supervision.
Sympathomimetics: Sympathomimetics are used for their vasoconstrictor/decongestant or bronchodilator effects.
Decongestants: Decongestants are used for temporary relief of nasal congestion due to colds or allergy. Given orally, they are less effective than topical nasal decongestants and have a potential for systemic side effects. Frequent or prolonged topical use may lead to local irritation and rebound congestion.
Bronchodilators: Ephedrine is common in these combinations; however, it stimulates cardiac (b1) receptors. Bronchodilation is weaker than with the catecholamines: a-adrenergic effects may decrease congestion of mucous membranes. Other b-active agents are effective bronchodilators, but pseudoephedrine is not.
Analgesics: Analgesics (eg, acetaminophen, aspirin, ibuprofen, sodium salicylate) are frequently included for symptoms of headache, fever, muscle aches, and pain.
Anticholinergics: Anticholinergics are included for their drying effects on mucous secretions. This action may be beneficial in acute rhinorrhea; however, drying of respiratory secretions may lead to obstruction. Traditionally, anticholinergics have been avoided in patients with asthma or chronic obstructive pulmonary disease (COPD); however, some patients respond well to these agents. Caution is still advised in this group. An anticholinergic for oral inhalation is available as a bronchodilator for maintenance of bronchospasm associated with COPD, including chronic bronchitis and emphysema.
Papaverine HCl: Papaverine HCl relaxes the smooth muscle of the bronchial tree and tractus duodenum, this drug mostly use for the diarrhea patients.
Barbiturates: Barbiturates are included for their sedative effects as “correctives” in combination with xanthines or sympathomimetics, which may cause CNS stimulation. The sedative efficacy of low doses (eg, 8 mg phenobarbital) is questionable.
Caffeine: Caffeine is included in some combinations for CNS stimulation to counteract antihistamine depression and to enhance concomitant analgesics.
Barbiturates, prochlorperazine, hydroxyzine, meprobamate, chlordiazepoxide: These components are used as sedatives and antianxiety agents.
Ergotamine tartrate: Ergotamine tartrate provides inhibition of the sympathetic nervous system.
Kaolin: Kaolin is used for its adsorbent properties.
Narcotic analgesics: Codeine, hydrocodone bitartrate, dihydrocodeine bitartrate, opium, oxycodone HCl, oxycodone terephthalate, meperidine HCl, propoxyphene HCl, propoxyphene napsylate.
Nonnarcotic analgesics: Acetaminophen, salicylates, salicylamide. Caffeine, a traditional component of many analgesic formulations, may be beneficial to certain vascular headaches.
Magnesium-aluminum hydroxides and calcium carbonate: Magnesium-aluminum hydroxides and calcium carbonate are used as buffers.
Barbiturates, acetylcarbromal, carbromal, and bromisovalum: Barbiturates, acetylcarbromal, carbromal, and bromisovalum are used for their sedative effects.
Promethazine HCl: Promethazine HCl (a phenothiazine derivative with antihistamine properties) is used for its sedative effect.
Belladonna alkaloids: Belladonna alkaloids are used as an antispasmodic.
Barbiturates, meprobamate, and antihistamines: Barbiturates, meprobamate, and antihistamines are used for their sedative effects.
Antacids: Antacids are used to minimize gastric upset from salicylates.
Caffeine: Caffeine, a traditional component of many analgesic formulations, may be beneficial in treating certain vascular headaches.
Belladonna: Belladonna alkaloids are used as antispasmodics, the medicine which popular for the colic abdominal patients.
Pamabrom: Pamabrom is used as a diuretic.
Cinnamedrine: Cinnamedrine, a sympathomimetic amine claimed to have a relaxant effect in the uterus, is used in products for premenstrual syndrome. Its real value has not been established.
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