PROTOBEX SYRUP

Indications

• Bronchospasm
• Chronic obstructive pulmonary disease (COPD)
• Asthma
• Cystic fibrosis
• Respiratory tract infections with excessive mucus

Dosage

Children: Refer to established guidelines for specific dosing information, as individual doses may vary based on clinical condition and response.

Adults: Refer to established guidelines for specific dosing information, as individual doses may vary based on clinical condition and response.

Mechanism of action

Aminoate acts as a respiratory stimulant by enhancing the activity of the respiratory centers in the brain. It increases the depth and rate of breathing, which facilitates improved gas exchange. Additionally, it may promote mucociliary clearance by stimulating mucus secretion and enhancing the action of cilia in the respiratory tract.

Pharmacodynamics

The pharmacodynamics of aminoate involves its action on the central nervous system, particularly in increasing the respiratory rate and volume. This leads to improved oxygenation and elimination of carbon dioxide. The expectorant properties enhance mucus production, aiding in the clearance of secretions from the airways, thus improving respiratory function in patients with obstructive pulmonary conditions.

Pharmacokinetics

Aminoate is absorbed through the gastrointestinal tract following oral administration. It is metabolized in the liver and has a variable half-life depending on individual patient factors and the formulation used. The drug is excreted primarily via the kidneys, with its metabolites being eliminated in urine. The onset of action typically occurs within 30 to 60 minutes of administration.

Pregnancy

The safety of aminoate during pregnancy has not been established. It is advisable to use caution and consult a healthcare professional before use.

Breast-feeding

Aminoate may be excreted in breast milk. Caution is advised when administering to breastfeeding mothers.

Storage

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

Indications

• Nutritional support in malnourished patients
• Post-operative recovery
• Management of malabsorption syndromes
• Support in conditions requiring enhanced protein intake

Dosage

Children: Refer to the BNF for Children for dosing recommendations.

Adults: Refer to specific formulations and BNF guidelines for appropriate dosing.

Mechanism of action

Hydrolysates increase the availability of amino acids and peptides for absorption in the intestines. The smaller size of these molecules compared to whole proteins facilitates their transport across the intestinal wall, allowing for quicker and more effective utilization by the body. This mechanism is particularly beneficial in patients with compromised digestive capabilities.

Pharmacodynamics

The pharmacodynamic effects of hydrolysates involve the supply of essential and non-essential amino acids, which are crucial for various metabolic processes, including protein synthesis, neurotransmitter production, and immune function. The rapid absorption of these peptides can lead to quicker recovery times in malnourished individuals or those undergoing surgical recovery.

Pharmacokinetics

Hydrolysates are rapidly absorbed in the gastrointestinal tract, with peak plasma concentrations occurring shortly after ingestion. The bioavailability of amino acids from hydrolysates is generally higher than that of intact proteins due to their smaller molecular size. The metabolism of amino acids occurs primarily in the liver, where they can be utilized for energy production or incorporated into new proteins. The elimination of amino acids happens through renal pathways, with excess being excreted in urine.

Pregnancy

Safety during pregnancy has not been established. Use only if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known if hydrolysate is excreted in human 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.

Indications

• Dermatitis
• Acne
• Rosacea
• Hyperpigmentation
• Skin aging

Dosage

Children: Refer to the BNF for Children for specific dosing guidelines for paediatric patients.

Adults: Refer to the BNF for specific dosing guidelines based on the condition being treated.

Mechanism of action

Niacinamide functions primarily as a precursor to NAD and NADP, which are crucial for numerous enzymatic reactions in the body. It is involved in the NAD salvage pathway, which recycles nicotinamide for NAD synthesis. This process is vital for cellular energy production and metabolic processes. Niacinamide also has anti-inflammatory properties, which may contribute to its effects in skin health.

Pharmacodynamics

Niacinamide exhibits various pharmacological effects, including enhancing skin barrier function, reducing inflammation, and improving skin pigmentation. It has been shown to modulate keratinocyte function, improve collagen synthesis, and decrease the synthesis of sebum, thereby providing beneficial effects in conditions like acne and rosacea.

Pharmacokinetics

Niacinamide is readily absorbed from the gastrointestinal tract. It is distributed widely throughout the body and can cross biological membranes. The metabolism of niacinamide primarily occurs in the liver through methylation and conjugation, and it is excreted in urine as metabolites. The half-life of niacinamide is approximately 1-2 hours, and its effects can be prolonged due to its role in NAD synthesis.

Pregnancy

No evidence of harm, but use only if clearly needed.

Breast-feeding

Considered safe to use while breastfeeding.

Storage

Store in a cool, dry place away from light.

Formulations

• {'type': 'Topical cream', 'concentration': 'Various concentrations available'}
• {'type': 'Oral tablets', 'concentration': '100 mg, 250 mg, 500 mg'}

Indications

• Dry skin
• Wound healing
• Dermatitis
• Eczema
• Skin irritation

Dosage

Children: For paediatric patients, refer to the BNF for Children for specific dosing recommendations.

Adults: For topical use, apply as needed to affected areas, typically 1-2 times daily.

Mechanism of action

Panthenol is enzymatically converted to pantothenic acid, which is a vital component of Coenzyme A. This cofactor is essential for numerous enzymatic reactions, particularly in protein metabolism within epithelial tissues. Additionally, dexpanthenol enhances fibroblast proliferation and accelerates re-epithelialization, facilitating wound healing and providing a protective barrier.

Pharmacodynamics

Pantothenic acid serves as a precursor to coenzyme A, which is crucial for the transfer of acetyl groups in various metabolic processes. It is involved in the synthesis of acetylcholine, a neurotransmitter that plays a vital role in the parasympathetic nervous system. Adequate levels of acetylcholine are necessary for normal intestinal function, including peristalsis, and a deficiency may lead to gastrointestinal issues such as adynamic ileus.

Pharmacokinetics

The pharmacokinetics of panthenol include its absorption, distribution, metabolism, and excretion. When applied topically, dexpanthenol is readily absorbed and metabolized into pantothenic acid. The systemic absorption is generally low when used in topical formulations, minimizing the risk of systemic side effects. The retention of moisture and enhancement of epithelial barrier function are key therapeutic benefits.

Pregnancy

Panthenol is generally considered safe for use during pregnancy, but it is advisable to consult a healthcare provider before use.

Breast-feeding

Panthenol is considered safe for use during breastfeeding; however, it is recommended to consult a healthcare professional.

Storage

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

Formulations

• Topical cream
• Topical ointment
• Topical solution

Indications

• Nutritional supplementation
• Muscle repair and growth
• Immune support
• Enzyme replacement therapy
• Hormonal regulation

Dosage

Children: Refer to specific product guidelines for dosing information, as protein requirements in children vary based on age, growth stage, and health status.

Adults: Refer to specific product guidelines for dosing information, as protein requirements can vary widely based on individual needs, activity levels, and clinical conditions.

Mechanism of action

Proteins exert their effects primarily through their structure and interactions with other molecules. They can function as enzymes, hormones, and antibodies, and their action is often mediated by binding to specific receptors or substrates, leading to a change in cellular activity or function. For example, enzymes catalyze biochemical reactions, while antibodies bind to antigens to facilitate immune responses.

Pharmacodynamics

The pharmacodynamics of proteins can vary significantly depending on the specific protein being considered. Generally, the effects of proteins are dose-dependent and influenced by their concentration, affinity for targets, and duration of action. Proteins can have a wide range of biological activities, including promoting cellular repair, regulating metabolism, and modulating immune responses.

Pharmacokinetics

The pharmacokinetics of proteins includes their absorption, distribution, metabolism, and excretion (ADME). Proteins are typically digested in the gastrointestinal tract into amino acids before being absorbed into the bloodstream. Once in circulation, proteins can be distributed throughout various tissues. They may have a variable half-life based on their structure and function, and they are primarily metabolized by the liver and excreted via the kidneys. The pharmacokinetic profile can be influenced by factors such as the route of administration and the presence of other substances.

Pregnancy

Generally considered safe, but high protein intake should be monitored to avoid potential risks.

Breast-feeding

Adequate protein intake is critical for lactating women to support milk production and quality.

Storage

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

Indications

• Management of menopausal symptoms
• Cardiovascular health improvement
• Cholesterol reduction
• Dietary protein source
• Potential role in cancer prevention

Dosage

Children: Refer to specific dietary guidelines and recommendations for children, as soya products can be part of a balanced diet.

Adults: Refer to specific dietary guidelines as soya is primarily consumed as a food source rather than a pharmacological agent.

Mechanism of action

Soya exerts its effects primarily through its isoflavones, which are phytoestrogens that can bind to estrogen receptors in the body. This action can modulate estrogen activity, leading to various physiological effects, such as alleviating menopausal symptoms and influencing lipid metabolism. Additionally, the protein in soya can help lower cholesterol levels and improve cardiovascular health by enhancing endothelial function and reducing inflammation.

Pharmacodynamics

The pharmacodynamics of soya is largely attributed to its isoflavone content, including genistein and daidzein. These compounds can mimic estrogen and may exert both estrogenic and anti-estrogenic effects depending on the tissue type. The consumption of soya has been associated with improvements in lipid profiles, reductions in blood pressure, and potential protective effects against certain cancers, particularly hormone-dependent cancers.

Pharmacokinetics

The bioavailability of isoflavones from soya varies but is generally well-absorbed following consumption. After ingestion, isoflavones undergo extensive metabolism in the liver and intestines, leading to the formation of various metabolites that can be detected in the plasma. The elimination half-life of these metabolites varies, but they are typically cleared from the body within hours to a few days, depending on individual metabolism and the amount consumed.

Contra-indications

• Hypersensitivity to soya or any of its components
• Severe soy allergy

Adverse effects

• Gastrointestinal discomfort
• Nausea
• Diarrhea
• Allergic reactions, including rash and itching
• Headache
• Fatigue

Interactions

• May interact with anticoagulants, increasing bleeding risk
• Potential interaction with thyroid medications, affecting thyroid hormone levels

Precautions

• Use with caution in individuals with a history of allergic reactions to legumes
• Monitor for possible hormonal effects in individuals with hormone-sensitive conditions

Pregnancy

Soya is generally considered safe in moderation during pregnancy, but high doses should be avoided due to potential hormonal effects.

Breast-feeding

Soya is usually considered safe during breastfeeding, but excessive consumption should be avoided as effects on infants are not fully understood.

Storage

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

Formulations

• Soybeans (whole or processed)
• Soy milk
• Soy protein isolate
• Soy flour
• Soy lecithin

Indications

• Vitamin deficiency syndromes (e.g., scurvy for vitamin C deficiency, rickets for vitamin D deficiency)
• Support for immune function
• Antioxidant support
• Bone health maintenance
• Vision health
• Energy metabolism support

Dosage

Children: Refer to the BNF for Children for specific vitamin dosing guidelines, which depend on age and nutritional requirements.

Adults: Refer to specific vitamin guidelines as dosage varies significantly depending on the type of vitamin and individual needs.

Mechanism of action

Vitamins function primarily as coenzymes or precursors for coenzymes in enzymatic reactions. For instance, B vitamins are involved in energy metabolism, while vitamins A, C, D, E, and K support various physiological functions including vision, antioxidant activity, calcium regulation, and blood clotting. Each vitamin has a unique mechanism of action based on its structure and role in the body.

Pharmacodynamics

Vitamins exert their effects at the cellular level, influencing metabolic pathways, gene expression, and immune responses. For example, vitamin D regulates calcium and phosphate homeostasis, while vitamin A is crucial for vision and immune function. Deficiencies in vitamins can lead to a range of disorders, highlighting their importance in maintaining health.

Pharmacokinetics

The pharmacokinetics of vitamins vary widely. Fat-soluble vitamins (A, D, E, and K) are stored in liver and adipose tissues and can be released into circulation as needed. Water-soluble vitamins (B-complex and C) are not stored and must be consumed regularly, with excess amounts excreted in urine. Absorption rates, half-lives, and distribution can also differ based on the specific vitamin and individual metabolic factors.

Interactions

• tretinoin+vitamin: Severe (increases risk of vitamin toxicity)
• retinoids+vitamin: Severe (increases risk of vitamin toxicity)
• retinoids+vitamin: Moderate (increases risk of toxicity)
• carbamazepine+vitamin: Unknown (decreases effects)
• cobicistat+vitamin: Unknown (increases exposure)
• vitamin D substances+digoxin: Unknown (increases risk of toxicity)
• idelalisib+vitamin: Unknown (increases exposure)
• clarithromycin+vitamin: Unknown (increases exposure)

Pregnancy

Consult healthcare professional before use. Vitamin supplementation during pregnancy should be carefully managed to avoid hypervitaminosis.

Breast-feeding

Consult healthcare professional before use. Some vitamins can pass into breast milk and may affect the infant.

Storage

Store in a cool, dry place, away from direct sunlight. Ensure it is kept out of reach of children.

Formulations

• {'name': 'Vitamin A', 'form': 'Capsule', 'strength': '10000 IU'}
• {'name': 'Vitamin D', 'form': 'Tablet', 'strength': '1000 IU'}
• {'name': 'Vitamin E', 'form': 'Softgel', 'strength': '400 IU'}

Mechanism of action

Panthenol is an alcohol derivative of pantothenic acid, a component of the B complex vitamins and an essential component of a normally functioning epithelium. Dexpanthenol, the active form of panthenol, is enzymatically cleaved to form pantothenic acid (Vitamin B5), which is an essential component of Coenzyme A that acts as a cofactor in many enzymatic reactions that are important for protein metabolism in the epithelium. Dermatological effects of the topical use of dexpanthenol include increased fibroblast proliferation and accelerated re-epithelialization in wound healing. Furthermore, it acts as a topical protectant, moisturizer, and has demonstrated anti-inflammatory properties.

Pharmacodynamics

Pantothenic acid is a precursor of coenzyme A, which serves as a cofactor for a variety of enzyme-catalyzed reactions involving transfer of acetyl groups. The final step in the synthesis of acetylcholine consists of the choline acetylase transfer of acetyl group from acetylcoenzyme A to choline. Acetylcholine is the neurohumoral transmitter in the parasympathetic system and as such maintains the normal functions of the intestine. Decrease in acetylcholine content would result in decreased peristalsis and in extreme cases adynamic ileus.