Tos Mai

Pharmacological properties

TOS-Mai - a combined drug that has an antitussive, mucolytic, expectorant, local anesthetic effect, which reduces cough, soreness and sore throat. the effect of the drug is due to the pharmacological properties of the components that make up its composition.

Dextromethorphan is an antitussive that is the D-stereoisomer of levorphanol. According to the mechanism of action, dextromethorphan, an antagonist of the medulla oblongata NMDA receptors, affects the central link of the cough reflex, resulting in a decrease in dry unproductive cough associated with irritation of the mucous membrane of the respiratory tract with colds. Its effect on the peripheral link of the cough reflex by suppressing afferent impulses coming from the mucous membrane of the upper respiratory tract was also noted. The severity of the antitussive effect is close to codeine, but unlike it does not cause dependence, it does not inhibit the respiratory center and activity of the ciliary epithelium of the respiratory tract, and does not have an analgesic effect.

Benzocaine is a highly active surface local anesthetic derived from PABA. It does not have a resorptive effect. The mechanism of action is associated with a decrease in the ionic permeability of nerve endings. As part of combined antitussive drugs, it reduces pain and sore throat.

Potassium guaiacol sulfonate is an expectorant. Helps reduce the viscosity of bronchial mucus, depolymerizes mucopolysaccharides and increases the activity of cilia of the ciliated epithelium of the respiratory tract. Reduces the surface tension and adhesive properties of sputum, reduces its viscosity and facilitates evacuation from the respiratory tract, transforming an unproductive cough into a productive one. It has a weak antiseptic and anesthetic effect.

Sodium benzoate is a direct-acting expectorant. When taken orally, it increases the secretion of bronchial glands, dilutes sputum and facilitates its evacuation from the respiratory tract. It has mild antibacterial and antifungal properties.

Pharmacokinetics After oral administration, dextromethorphan is rapidly absorbed in the digestive tract, has a high bioavailability. The antitussive effect develops 15–30 minutes after ingestion and lasts 5–6 hours. C_max in blood plasma is reached after 2 hours. It is actively metabolized in the liver by N- and O-demethylation. T_½ is 6.5 hours. It is excreted mainly by the kidneys in the form of metabolites, and only a small amount is excreted unchanged.

Potassium guaiacol sulfonate is rapidly absorbed in the digestive tract. C_max in the blood is reached after 1-2 hours. The therapeutic concentration is maintained for about 6 hours. T_½ 1-2 hours. Excreted in sputum and excreted by the kidneys in the form of metabolites and unchanged.

Indications

Symptomatic treatment of dry irritating cough with ARVI and infectious and inflammatory diseases of the upper and lower respiratory tract. in preparing the patient for bronchoscopy.

Application

Children aged 12 years and older and adults are usually prescribed 1-2 tablets 4-6 times a day (but not more than 16 tablets per day); children aged 6-12 years - 1 tablet 4 times a day (no more than 8 tablets per day).

In order to achieve a faster action of the drug, tablets should be slowly absorbed in the oral cavity.

Contraindications

Hypersensitivity to dextromethorphan, amide anesthetics and other components of the drug, respiratory failure, BA, pulmonary emphysema.

Side effects

From the digestive system: nausea, vomiting, abdominal pain, diarrhea.

From the side of the central nervous system: general weakness, drowsiness, headache.

From the immune system: allergic reactions, including rash, itching, flushing of the face, angioedema.

special instructions

You should not exceed the recommended doses of the drug, combine the use of the drug with the intake of alcoholic beverages, and also use the drug for chronic cough associated with BA and pulmonary emphysema. with caution, prescribe the drug in people with liver diseases.

Use during pregnancy and lactation. There is no teratogenic and embryotoxic effect of the drug, however, given the lack of adequate clinical trials, the drug can be used during pregnancy only as prescribed by the doctor in the case when the expected benefit to the mother outweighs the potential risk to the fetus. Due to the lack of information on the use of the drug during lactation, it should not be used by women during this period.

Children. Tos May is prescribed for children over 6 years old.

The ability to influence the reaction rate when driving vehicles or working with other mechanisms. In some patients, after using the drug, drowsiness, a decrease in the reaction rate may occur, which should be borne in mind when driving vehicles.

Interactions

The simultaneous use of the drug with antidepressants - MAO inhibitors, furazolidone, procarbazine should be avoided due to an increased risk of central nervous system excitation, the development of antigens and hyperthermia. drugs that inhibit the central nervous system, alcohol with combined use enhance the sedative effect of the drug. quinidine slows down the metabolism of dextromethorphan in the liver, increasing its concentration in the blood.

Overdose

With a significant overdose, symptoms may occur due to dextromethorphan - drowsiness, dizziness, ataxia, irritability, hyperactivity, confusion, blurred vision, nystagmus, respiratory depression, nausea, vomiting; potassium guaiacol sulfonate - drowsiness, nausea, vomiting; benzocaine - in very rare cases, methemoglobinemia. there is no specific antidote, symptomatic treatment.

Storage conditions

At a temperature not exceeding 25 ° c.