Terbutaline and Bromaxine combination use BRONCHODILATO and mucolytic agent

1. In various disorders such as acute and chronic bronchitis and
other bronchospastic disorders such as eosinophilia, there is a
spasm of the bronchial muscles and irritation of the bronchial
mucous membrane, leading to breathlessness and cough. In the
symptomatic management of these disorders, the mainstay of
treatment consists of bronchodilators and mucolytic agents.
Bronchodilators by spasmolytic action, relieve broncho-
constriction, thus relieving patients from troublesome
breathlessness, while the mucolytic agent facilitates expulsion
of accumulated sputum by reducing its viscosity and stickiness.
Terbutaline is a B2 selective bronchodilator drug. It is devoid of
any significant side effects on the cardiovascular system when
taken in correct dosage. Terbutaline is variably absorbed from
the gastrointestinal tract and is subject to fairly extensive first-
pass metabolism in the liver. It is excreted in the urine partly as
metabolites and partly as unchanged Terbutaline.

2. Bromhexine is a mucolytic agent. It renders the sputum less
viscous and less sticky and thereby facilitates its easy expulsion
from the respiratory tract. Bromhexine is rapidly absorbed from
the gastrointestinal tract and about 85% to 90% of a dose is
excreted in the urine mainly as metabolites. Bromhexine
produces a rarefaction and fragmentation of
mucopolysaccharide fibres in the sputum. By this action, it
reduces the viscosity of the sputum and hence is considered
the drug of choice in conditions associated with productive
cough.
INDICATIONS:
In the symptomatic treatment of cough in acute and chronic
bronchitis and other bronchospastic disorders such as
eosinophilia and in smoker's cough.

3. ADVERSE EFFECTS:
The adverse effects are due to the Ingredients in it. Terbutaline
is a B2 selective sympathomimetic agent.
Hence it has side effects similar to those of sympathomimetic
agents
e.g. CNS side effects like anxiety, fear, tremor, restlessness,
confusion
There may be reduction of appetite and nausea and vomiting
may occur. Very rarely pulmonary oedema may occur. Since
Terbutaline is a B2 selective bronchodilator it is devoid of side
effects related to the cardiovascular system. Gastrointestinal
side effects may occur occasionally with Bromhexine and a
transient rise in the serum aminotransferase values has been
reported.
PRECAUTIONS :
Should be used with caution in patients with hyperthyroidism.
DRUG INTERACTIONS:

4. Theophylline when given with Terbutaline can enhance the
response to Terbutaline. It can also lead to a fall in the serum
potassium level.
Terbutaline can reduce the serum theophylline concentrations
by increasing its systemic clearance.