GRAYS-THROAT-LOZENGES COMBINATION PRODUCT THROAT LOZENGE

Indications

• Topical pain relief
• Muscle aches
• Joint pain
• Inflammation

Dosage

Children: For children, the

Adults: For topical application, camphor is usually applied as needed to the affected area, following the instructions on the specific product used. Consult the product label or a healthcare professional for detailed dosing guidelines.

Mechanism of action

Camphor activates the transient receptor potential vanilloid 1 (TRPV1) and TRPV3 channels, which are involved in sensing pain and temperature. It requires higher concentrations to activate TRPV1 compared to capsaicin but notably desensitizes TRPV1 more rapidly and completely. This action is enhanced under inflamed conditions through phospholipase C-coupled receptor stimulation. The distinct activation pathways of camphor contribute to its analgesic effects, making it effective in reducing pain sensitivity.

Pharmacodynamics

The pharmacodynamic properties of camphor are primarily related to its interaction with TRPV1 and TRPV3 channels. By activating these receptors, camphor induces a sensation of warmth and can result in analgesia through sensory nerve excitation and subsequent desensitization. This mechanism is similar to that of other topical analgesics like capsaicin and menthol but is characterized by a faster desensitization of TRPV1. Additionally, camphor's effects may include local vasodilation and increased blood flow to the area of application, which can further alleviate pain and inflammation.

Pharmacokinetics

Camphor is absorbed through the skin when applied topically. Its pharmacokinetic profile involves distribution to various tissues, where it can exert local effects. The metabolism of camphor occurs primarily in the liver, and it is eliminated from the body mainly through urine. The onset of action is typically rapid due to its topical application, and the duration of effect may vary depending on the formulation and concentration used.

Adverse effects

• Skin irritation
• Allergic reactions
• Nausea
• Vomiting
• Dizziness

Precautions

• Use with caution in individuals with sensitive skin
• Avoid contact with eyes and mucous membranes
• Do not apply to broken or irritated skin
• Keep out of reach of children

Pregnancy

Camphor should be used with caution during pregnancy. It is advisable to consult a healthcare professional before use.

Breast-feeding

Camphor should be used with caution while breastfeeding. Consult a healthcare professional for advice.

Storage

Store in a cool, dry place, away from direct sunlight and heat.

Formulations

• Topical ointments
• Liniments
• Creams
• Gels

Indications

• Topical analgesic for muscle and joint pain
• Cough suppressant in cough drops and lozenges
• Relief of minor throat irritation
• Cooling agent in various cosmetic and personal care products

Dosage

Children: Refer to BNF for Children for specific dosing guidelines, as doses may vary based on age and formulation.

Adults: For topical use, apply a thin layer to the affected area not more than 3 to 4 times daily. For cough drops, follow the product-specific instructions as per the formulation.

Mechanism of action

Menthol acts as an agonist for the transient receptor potential subtype M8 (TRPM8), a non-selective cation channel that is activated by cold temperatures. This activation leads to calcium influx in mast cells, inducing the release of histamine, which can trigger allergic responses such as urticaria, asthma, and rhinitis. Menthol's ability to induce histamine release via TRPM8 suggests potential therapeutic applications for TRPM8 antagonists in managing cold- and menthol-induced allergies.

Pharmacodynamics

Menthol produces a cooling effect by stimulating sensory neurons that convey cold sensations. It interacts with TRPM8 channels, leading to the activation of intracellular signaling pathways that can result in vasodilation and increased blood flow to the area of application. This cooling sensation can provide symptomatic relief in conditions characterized by pain or irritation.

Pharmacokinetics

Menthol is absorbed through the skin and mucous membranes, with systemic effects depending on the route of administration. Its bioavailability can vary, and it is metabolized primarily in the liver. The elimination half-life and excretion pathways have not been extensively characterized, but menthol is generally considered to have a rapid onset of action with effects lasting for a few hours.

Adverse effects

• Allergic reactions
• Urticaria
• Asthma
• Rhinitis
• Skin irritation

Precautions

• Use with caution in patients with known allergies to menthol or related compounds
• May exacerbate asthma in sensitive individuals

Pregnancy

There are no well-controlled studies of menthol in pregnant women. Menthol should be used during pregnancy only if clearly needed.

Breast-feeding

Menthol is excreted in breast milk. Caution should be exercised when administering to nursing mothers.

Storage

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

Formulations

• Topical ointment
• Cream
• Liquid

Indications

• Irritable bowel syndrome
• Dyspepsia
• Nausea
• Headaches
• Respiratory congestion

Dosage

Children: Refer to the BNF for Children for appropriate dosing guidelines.

Adults: Refer to the relevant product-specific information for dosing recommendations, as peppermint formulations can vary widely.

Mechanism of action

The primary active component, menthol, works by activating the TRPM8 (transient receptor potential cation channel subfamily M member 8) ion channel, which is involved in the sensation of cold and cooling. This action can lead to a localized anesthetic effect, reducing pain and discomfort. Additionally, menthol can cause relaxation of smooth muscle in the gastrointestinal tract, aiding in the relief of digestive symptoms.

Pharmacodynamics

Peppermint exhibits antispasmodic effects, particularly in the gastrointestinal tract, by relaxing the smooth muscles. It also has a mild analgesic effect due to its cooling sensation, which can provide symptomatic relief in various conditions. Furthermore, peppermint oil may have antimicrobial properties, contributing to its use in treating certain infections.

Pharmacokinetics

Menthol is rapidly absorbed after oral administration and is metabolized in the liver. The peak plasma concentration typically occurs within a few hours. The elimination half-life of menthol is approximately 1.5 to 2 hours, and it is primarily excreted in the urine as metabolites. The pharmacokinetics of peppermint oil can vary based on the formulation and route of administration.

Interactions

• peppermint oil + lomitapide: Unknown (increases exposure)

Pregnancy

Peppermint is generally considered safe for use in pregnancy when used in culinary amounts. However, high doses should be avoided due to potential uterine stimulation.

Breast-feeding

Peppermint is considered safe during breastfeeding when used in culinary amounts. Caution is advised with high doses as effects on the infant are not well studied.

Storage

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

Formulations

• Peppermint oil
• Peppermint extract
• Peppermint tea

Indications

• Immunological disorders
• Infections (bacterial and fungal)
• Inflammatory conditions

Dosage

Children: Refer to BNF for Children for specific dosages pertinent to paediatric patients.

Adults: Refer to BNF for specific dosages, as they can vary based on indication and formulation.

Mechanism of action

Thymol modulates macrophage activity by enhancing phagocytosis and increasing the proliferation of splenocytes, acting as a mitogen. It improves macrophage uptake capacity through increased membrane fluidity and enhances lysosomal activity. Thymol also stimulates the respiratory burst in macrophages, leading to increased generation of superoxide anions. Additionally, it shows anti-inflammatory effects by decreasing the secretion of pro-inflammatory cytokines such as TNF-alpha, IL-1beta, and PGE(2).

Pharmacodynamics

Thymol exhibits various pharmacodynamic effects including antimicrobial, antifungal, and immunomodulatory activities. Its ability to enhance macrophage function suggests a role in boosting the immune response, potentially benefiting conditions characterized by immune dysfunction. The compound also demonstrates antioxidant properties, contributing to its anti-inflammatory effects.

Pharmacokinetics

The pharmacokinetic profile of thymol is not fully characterized; however, it is known to be readily absorbed and distributed in the body due to its lipophilic nature. Metabolism occurs in the liver, with excretion primarily through the urine. The exact half-life and elimination pathways require further investigation to provide a comprehensive overview.

Pregnancy

There is insufficient data on the use of thymol during pregnancy. Caution is advised.

Breast-feeding

Limited information is available regarding the excretion of thymol in human milk. Caution is recommended.

Storage

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

Mechanism of action

Camphor is a naturally occurring compound that is used as a major active ingredient of balms and liniments supplied as topical analgesics. ... Capsaicin and menthol, two other topically applied agents widely used for similar purposes, are known to excite and desensitize sensory nerves by acting on two members of transient receptor potential (TRP) channel superfamily: heat-sensitive TRP vanilloid subtype 1 (TRPV1) and cold-sensitive TRP channel M8, respectively. Camphor has recently been shown to activate TRPV3, and here /investigators/ show that camphor also activates heterologously expressed TRPV1, requiring higher concentrations than capsaicin. Activation was enhanced by phospholipase C-coupled receptor stimulation mimicking inflamed conditions. Similar camphor-activated TRPV1-like currents were observed in isolated rat DRG neurons and were strongly potentiated after activation of protein kinase C with phorbol-12-myristate-13-acetate. Camphor activation of rat TRPV1 was mediated by distinct channel regions from capsaicin, as indicated by camphor activation in the presence of the competitive inhibitor capsazepine and in a capsaicin-insensitive point mutant. Camphor did not activate the capsaicin-insensitive chicken TRPV1. TRPV1 desensitization is believed to contribute to the analgesic actions of capsaicin. /The authors/ found that, although camphor activates TRPV1 less effectively, camphor application desensitized TRPV1 more rapidly and completely than capsaicin. Conversely, TRPV3 current sensitized after repeated camphor applications, which is inconsistent with the analgesic role of camphor. /Investigators/ also found that camphor inhibited several other related TRP channels, including ankyrin-repeat TRP 1 (TRPA1). The camphor-induced desensitization of TRPV1 and block of TRPA1 may underlie the analgesic effects of camphor.

Mechanism of action

Exposure to low temperatures often causes allergic responses or urticaria. Similarly, menthol, a common food additive is also known to cause urticaria, asthma, and rhinitis. However, despite the obvious clinical implications, the molecular mechanisms responsible for inducing allergic responses to low temperatures and menthol have not been determined. Because a non-selective cation channel, transient receptor potential subtype M8 (TRPM8) is activated by cold and menthol, we hypothesized that this channel mediates cold- and menthol-induced histamine release in mast cells. Here, we report that TRPM8 is expressed in the basophilic leukemia mast cell line, RBL-2H3, and that exposure to menthol or low temperatures induced Ca(2+) influx in RBL-2H3 cells, which was reversed by a TRPM8 blocker. Furthermore, menthol, a TRPM8 agonist, induced the dose-dependent release of histamine from RBL-2H3 cells. When TRPM8 transcripts were reduced by siRNA (small interfering RNA), menthol- and cold-induced Ca(2+) influx and histamine release were significantly reduced. In addition, subcutaneous injection of menthol evoked scratching, a typical histamine-induced response which was reversed by a TRPM8 blocker. Thus, our findings indicate that TRPM8 mediates the menthol- and cold-induced allergic responses of mast cells, and suggest that TRPM8 antagonists be viewed as potential treatments for cold- and menthol-induced allergies. /DL-Menthol/ Menthol's characteristic cooling sensation is due, in part, to the activation of sensory neurons generally termed transient receptor potential (TRP) channels, in particular transient receptor potential melastatin family member 8 (TRPM8) and transient receptor potential subfamily A, member 1 (TRPA1). Menthol acts upon TRPM8 receptors by rapidly increasing intracellular calcium and mobilizing calcium flux through the channels to induce cold response signals at the application site. Aside from its cold-inducing sensation capabilities, menthol exhibits cytotoxic effects in cancer cells, induces reduction in malignant cell growth, and engages in synergistic excitation of GABA receptors and sodium ion channels resulting in analgesia. /DL-Menthol/ In recent years, the transient receptor potential melastatin member 8 (TRPM8) channel has emerged as a promising prognostic marker and putative therapeutic target in prostate cancer. We have found that forced overexpression of TRPM8 in PC-3 cells can inhibit the cell proliferation and motility probably through the TRPM8 activation. In this study, we aimed to investigate whether activating the TRPM8 channel by its selective agonist menthol can inhibit the proliferation and motility of androgen-independent prostate cancer (AIPC) with remarkable expression of TRPM8. Menthol is a naturally occurring compound, which has been widely used in cosmetics and pharmaceutical products, and also as flavoring in food. DU145 cells are androgen-independent but have a remarkable expression of TRPM8. The demonstration of the existence of TRPM8 and the absence of TRPA1 in DU145 cells provided the foundation for the following experiments, because both TRPM8 and TRPA1 are molecular targets of menthol. The outcome of MTT assay indicated that menthol inhibited the cell growth (p < 0.01). Cell cycle distribution and scratch assay analysis revealed that menthol induced cell cycle arrest at the G(0)/G(1) phase (p < 0.01). Furthermore, menthol inhibited the migration of DU145 cells by downregulating the focal-adhesion kinase. So it suggests that the activation of the existing TRPM8 channels may serve as a potential and pragmatic treatment for those AIPC with remarkable expression of TRPM8, and menthol is a useful compound for future development as an anticancer agent. /DL-Menthol/

Mechanism of action

The potent role of thymol, a natural compound, in modulation of macrophage activity was evaluated by determining all the sequential steps involved during phagocytosis. We found a significant increase in the proliferation of splenocytes in the presence of thymol and it proved to be a good mitogen. Uptake capacity of macrophages was enhanced due to increased membrane fluidity after treatment with thymol and it also increases lysosomal activity of macrophages. Data of superoxide anion generation revealed the involvement of thymol in the generation of respiratory burst as it potentiated this property of macrophages at a concentration of 150 uM. In the case of TNF-a, IL-1beta and PGE(2) a decreased level of secretion was observed 154 pg/mL, 736.1 pg/mL, and 151 pg/mL respectively when compared with lipopolysaccharide treated cells, where the level of these cytokines was significantly high. We also determined the anti-complementary activity of thymol which showed to be more effective than rosmarinic acid. Thus, the results obtained from the study suggest the potential role of thymol as a natural immunostimulatory drug which can be used in the treatment of various immunological disorders.