ASHIENRO BH SOLUTION (Each ml contains Enrofloxacin BP 200mg/ Bromehexine HCL BP 15mg

Indications

• Chronic bronchitis
• Chronic obstructive pulmonary disease (COPD)
• Acute bronchitis
• Respiratory infections with excessive mucus production

Dosage

Children: Refer to the specific product information for dosing recommendations.

Adults: Refer to the specific product information for dosing recommendations.

Mechanism of action

Bromehexine acts by cleaving glycoprotein bonds in mucus, thereby reducing its viscosity and enhancing mucociliary clearance. This facilitates the expulsion of mucus from the respiratory tract, promoting better airflow and reducing the risk of infections.

Pharmacodynamics

Bromehexine enhances mucus secretion and stimulates the production of surfactant in the alveoli, which further aids in the clearance of mucus. It also has some anti-inflammatory properties, which can contribute to reduced symptoms of airway inflammation. The onset of action is typically observed within a few hours after administration, with a peak effect occurring within 1 to 2 days of consistent use.

Pharmacokinetics

Bromehexine is well absorbed from the gastrointestinal tract, with peak plasma concentrations reached within 1 to 2 hours post-administration. It is metabolized in the liver, with a half-life of approximately 8 to 12 hours. The drug is excreted primarily via the kidneys, with metabolites found in urine. Renal impairment may alter the pharmacokinetics of bromehexine, necessitating caution in patients with compromised renal function.

Adverse effects

• Gastrointestinal disturbances
• Nausea
• Vomiting
• Diarrhea
• Allergic reactions

Precautions

• Use with caution in patients with peptic ulcers
• Consider potential hypersensitivity reactions

Pregnancy

Bromhexine is generally not recommended during pregnancy unless clearly needed, as there is limited data on its safety.

Breast-feeding

Bromhexine is excreted in breast milk, caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place away from direct sunlight, at a temperature below 25°C.

Formulations

• Tablet
• Syrup
• Solution for inhalation

Indications

• Bacterial infections
• Respiratory tract infections
• Urinary tract infections
• Skin infections
• Gastrointestinal infections

Dosage

Children: Refer to the BNF for Children for appropriate dosing in paediatric patients.

Adults: Refer to the specific product guidelines for dosing information, as it can vary based on the indication and formulation used.

Mechanism of action

Enrofloxacin exerts its antibacterial effect through the inhibition of bacterial DNA gyrase and topoisomerase IV, which are essential enzymes for DNA replication and transcription. By interfering with these enzymes, enrofloxacin disrupts the normal function of the bacterial cell, leading to cell death.

Pharmacodynamics

Enrofloxacin has a bactericidal effect, meaning it kills bacteria rather than merely inhibiting their growth. Its activity is concentration-dependent, meaning that higher concentrations lead to more significant antibacterial effects. The drug has a broad spectrum of activity against many gram-negative bacteria, including Pseudomonas aeruginosa, as well as some gram-positive organisms.

Pharmacokinetics

Enrofloxacin is well-absorbed after oral administration, with peak plasma concentrations typically achieved within 1 to 2 hours. It is widely distributed throughout the body, including into tissues and fluids, and has good penetration into the central nervous system. The elimination half-life varies but is generally between 4 to 8 hours in humans. Enrofloxacin is primarily metabolized in the liver, and its metabolites, including ciprofloxacin, are also active against bacteria.

Contra-indications

• Hypersensitivity to enrofloxacin or any of its components
• Use in growing animals due to potential effects on cartilage development

Adverse effects

• Gastrointestinal disturbances such as vomiting and diarrhea
• Central nervous system effects including seizures and ataxia
• Tendon rupture or damage, particularly in larger breed dogs
• Possible cartilage damage in young animals

Interactions

• Antacids or products containing aluminum, magnesium, or iron may reduce the absorption of enrofloxacin
• Cationic agents may interfere with its antimicrobial activity
• Concurrent use with other nephrotoxic drugs may increase the risk of renal toxicity

Precautions

• Use with caution in animals with a history of seizures or renal impairment
• Monitor for signs of adverse reactions during therapy
• Not for use in animals with known hypersensitivity to fluoroquinolones

Pregnancy

Safety during pregnancy has not been established, use only if benefits outweigh risks.

Breast-feeding

Safety during lactation has not been fully established, use with caution.

Storage

Store in a cool, dry place, away from light. Keep out of reach of children.

Formulations

• Injectable solution
• Oral tablets
• Oral suspension