Common cold expectorants

Another potential benefit of UHPLC is its capability of solving the most challenging separation tasks in pharmaceutical analysis. Figure 9.4 shows a UPLC method developed to analyze pharmaceutical formulations used to treat the common cold. Cold products often contain multiple active ingredients to treat different symptoms and can contain decongestants, antihistamines, pain relievers, cough suppressants, expectorants, and numerous excipients of various polarities. The analysis of a total of 20 components was achieved within 10 min. 

Mucous airway obstruction. Mu-colytics, such as acetylcysteine, split disulfide bonds in mucus, hence reduce its viscosity and promote clearing of bronchial mucus. Other expectorants (e.g., hot beverages, potassium iodide, and ipecac) stimulate production of watery mucus. Acetylcysteine is indicated in cystic fibrosis patients and inhaled as an aerosol. Whether mucolytics are indicated in the common cold and whether expectorants like bromohexine or am-broxole effectively lower viscosity of bronchial secretions may be questioned. 

Myrrh has antimicrobial, astringent, carminative, expectorant, anticatarrhal, antiseptic, and vulnerary properties. Traditionally, it has been used for aphthous ulcers, pharyngitis, respiratory catarrh, common cold, furunculosis, wounds and abrasions, and specifically for mouth ulcers, gingivitis, and pharyngitis. 

Medici TC, Shang H, Grosgurin P et al (1985) No demonstrable effect of sobrerol as an expectorant in patients with stable chronic bronchial diseases. Bull Exp Physiopathol Respir 21 477-83 Melchart D, Linde K, Fischer P et al (1999) Echinacea for preventing and treating the common cold, Cochrane Database Syst Rev Issue 1, Art No, CD000530 Melchior J, Spasov AA, Ostrovskij OV et al (2000) Double-blind, placebo-controlled pilot and phase 111 study of activity of standardized Andrographis paniculata Herba Nees extract fixed combination (Kan Jang) in the treatment of uncomplicated upper respiratory tract infection. Phytomedicine 7 341-350... 

Traditional use The plant has been nsed in Central Asian folk medicine since ancient times, as an anticonvulsant, vermifuge, and to treat some nervous diseases. The gum-resin is used in Chinese medicine as a restorative and tonic for hysterics, neurasthenia and vegetative neurosis, and to treat some skin diseases and common colds, as an expectorant and anticonvulsant, and mixed with other drug substances to treat lung mberculosis, exudative diathesis, lymphadenitis, and osteitis. Avicenna used this plant to treat tumors, jaundice, and other Aver diseases, as well as stomach, kidney, and spleen diseases, and as a diuretic and hemostatic for uterine bleeding (Khalmatov and Khabibov 1976 Kurmukov and Akhmedkhodzhaeva 1994). 

The opioid derivatives most commonly used as antitussives are dextromethorphan, codeine, levopropoxyphene, and noscapine (levopropoxyphene and noscapine are not available in the USA). They should be used with caution in patients taking monoamine oxidase inhibitors (see Table 31-5). Antitussive preparations usually also contain expectorants to thin and liquefy respiratory secretions. Importantly, due to increasing reports of death in young children taking dextromethorphan in formulations of over-the-counter "cold/cough" medications, its use in children less than 6 years of age has been banned by the FDA. Moreover, due to variations in the metabolism of codeine, its use for any purpose in young children is being reconsidered. 

When an individual has a cold or other respiratory infection, it is common to have rather thick mucous that is difficult to expectorate. Expectorants are medications that loosen the secretions making it easier for the patient to cough up and expel the mucous. They work by increasing the fluid output of the respiratory tract and decrease the adhesiveness and surface tension to promote removal of viscous mucus. 

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