Coldko Nam Ha effervescent tablet treats the symptoms of the flu (5 tablets)

Dosage form Box of 5 tablets
Specifications Acetaminophen, chlorpheniramine, dextromethorphan
Ingredient Rhinitis, allergic rhinitis, fever, headache, body aches

Ingredient

Composition information	Content
Acetaminophen	500mg
Chlorpheniramine	2mg
Dextromethorphan	10mg

Uses

indications

Coldko 5 -tablet effervescent tablets are indicated in the following cases:

headache, fever, uncomfortable body aches, runny nose, stuffy nose, sneezing, cough.

Pharmacological

Clorpheniramin Maleat is an antihistamine with very little sedative effects. The antihistamine effect of chlorpheniramin maleat through the block of the h1 receptor of the acting cells.

dextromethophan hydrobromid is a cough reduction drug that works on the cough center in the brain. Used for a temporary cough due to mild stimulation in the bronchus and throat as usual cold or inhalation of stimulants, most effective in the treatment of chronic cough, no phlegm. The drug is often combined with many other substances to treat the upper respiratory symptoms.

paracetamol is a metabolic substance that has the activity of phenacetin. The drug acts on the central cashew center in the hypothalamus, causing cooling, increasing heat due to vasodilation and increasing peripheral blood flow reduces body temperature in the fever, but rarely reduces normal heat body.

pharmacokinetics

absorption:

chlorpheniramin maleat absorbs well after drinking and appears in plasma within 30 - 60 minutes. Plasma peak concentration reaches 2.5 to 6 hours after drinking. Low bioavailability, reaching 25-50%.

Dextromethorphan quickly absorbed through the gastrointestinal tract and works within 15 - 30 minutes after drinking.

Paracetamol is absorbed quickly and almost entirely through the gastrointestinal tract. The peak concentration of plasma is within 30 - 60 minutes after drinking with the dose of treatment.

Distribution:

About 70% of the drug during the circulation is linked to the protein. The distribution volume is about 2.5-3.2 liters/kg (adults) and 3.8 liters/kg (children). Paracetamol is quickly and evenly distributed in most body tissues. About 25% Paracetamol in the blood combined with plasma protein.

Metabolism:

chlorpheniramin maleat is fast and highly metabolized. The metabolites include Desmethyl-Didesmethyl-Clorpheniramin and some unknown substances, one or more of them are active. The concentration of chlorpheniramine in serum is not correlated in accordance with the antihistamine effect because there is an unknown metabolic substance that also works.

dextromethorphan is metabolized in the liver.

paracetamol is n-hydroxylation by cytochrom P450 to create N-acetyl-Benzoquinonimin (NAPQ), an intermediate reaction. This metabolic substance normally reacts with sulfhydryl groups in glutathion and is dimidated. However, if taking high doses of paracetamol, this metabolic is formed in sufficient amount to exhaust the glutathion of the liver; In that situation, NAPQ is not connected with glutathion toxic to liver cells, leading to inflammation and can lead to liver necrosis.

Era:

Clorpheniramin Maleat is excreted mainly in urine in a constant or metabolic form, the excretion depends on the pH and the urine flow. The sale time is from 12 - 15 hours, in patients with chronic renal impairment, half -life excreted up to 280 - 330 hours.

dextromethorphan is excreted in the urine in the form of constant and Demethyl metabolites.

Paracetamol's waste sale time is 1.25 - 3 hours, which can last for toxic doses or in patients with liver damage. After the treatment dose, 90 - 100%of the urine can be found on the first day, mainly after the liver combination with glucuronic acid (about 60%), sulfuric acid (about 35%) or cysteine (about 3%); Small amounts of hydroxyl metabolites are found - chemical and reducing acetyl. Children are less likely to glucuro than drugs than adults.

Before taking Coldko Nam Ha effervescent tablet treats the symptoms of the flu (5 tablets)

How to use

Take oral use.

Put the effervescent tablet and completely dissolve in about 200 ml of water before drinking.

Dosage

Adults and children over 12 years: take 1 capsule/time, no more than 6 tablets a day.

Children from 7 to 12 years old: Take ½ - 1 tablet/time, no more than 4 tablets a day.

Children from 2 to 6 years old: Take ½ capsules/time, no more than 2 tablets a day.

Take medicine each time 4 - 6 hours apart.

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose?

Symptoms and overdose signs include: sedation, naughty stimulation often the central nervous system, mental disorders, seizures, apnea, convulsions, anti -secretion effects Acetylcholin, tone and cardiovascular disorder reaction, arrhythmia. ipecacuanha. Then use activated carbon and bleach to limit absorption. It is possible to treat convulsions with intravenous diazepam or phenytoin intravenously. Blood transfusion may be required.

Overdose Dextromethorphan:

Symptoms such as vomiting, nausea, drowsiness, blurred vision, eyeball, urination, numbness, hallucinations, loss of air conditioning, respiratory failure, convulsions.

The liver necrosis depends on the most serious acute toxic effect due to overdose and may cause death. Nausea, vomiting, abdominal pain usually occur within 2-3 hours after taking the poisoning dose of the drug. When taking paracetamol. Next can be inhibiting the central nervous system: dumbfounded, lower body temperature, tired, fast breathing, shallow; Fast circuit, weak, irregular, low blood pressure and circulatory failure.

Vascular collapse due to relative hypoxia and central inhibition effects, this effect only occurs in huge doses. Shock may occur if a lot of vasodilation. The suffocating convulsions may occur. Often coma occurs before dying suddenly or after a few days of coma.

Clinical signs of liver damage become clearly within 2 to 4 days after taking toxic doses. Aminotransferase plasma increases (sometimes very high) and the concentration of bilirubin in plasma can also increase; In addition, when the liver lesions spread, the prothrombin time will last.

may be 10% of patients with untreated poisoning that have serious liver damage; Among them 10% to 20% finally die from liver failure. Acute renal failure also occurs in some patients. The liver biopsy detects the central necrosis of the lobe except the area around the door vein. In cases of non -death, liver lesions recover after weeks or months.

Treatment: Early diagnosis is important in the treatment of paracetamol overdose. There are methods to quickly determine the concentration of drugs in plasma. However, do not delay treatment while waiting for the test results if the history is suggested to overdose. When severe poisoning, it is important to treat positive support. Need to wash the stomach in any case, preferably within 4 hours after drinking.

The main detoxification is the use of sulfhydryl compounds, perhaps partly due to the addition of glutathion reserves in the liver. N-acetylcystein works when taken or intravenously. It must be used to detoxify immediately, as soon as possible if less than 36 hours after taking paracetamol. Treatment with n-acetylcysteine is more effective when giving the drug for less than 10 hours after taking paracetamol.

When drinking, dilute N-acetylcystein solution with water or drink without alcohol to achieve a 5% solution and must be taken within 1 hour after mixing. Give N-acetylcystein oral at the first dose of 140 mg/kg, then give 17 more doses, each dose of 70 mg/kg every 4 hours apart. Termination of treatment if the paracetamol test in plasma shows the risk of low liver toxicity.

Can also use n-acetylcystein by vein line:

The initial dose is 150 mg/kg, mixed in 200 ml of 5%glucose, intravenous injection for 15 minutes; Then intravenously dose of 50 mg/kg in 500 ml of 5% glucose for 4 hours; Next is 100 mg/kg in 1 liter of solution within the next 16 hours. ADR of N-acetylcystein includes skin rash (including urticaria, no need to stop the drug), nausea, vomiting, diarrhea, and anaphylactic reaction. If you have used activated carbon before using methionin, you must remove activated carbon from the stomach first. Also can use activated carbon and/or salt bleach because they have the ability to reduce paracetamol absorption. However, if close to the next dose, skip the forgotten dose and take the next dose at the time as planned. Do not use double the prescribed dose.

Side Effects

When using Coldko 5 -tablet effervescent tablets, you can experience unwanted effects (ADR).

Common, ADR> 1/100

Skin: Red or urticaria.

Uncommon, 1/1000

Body: Drowsy, dry mouth, fatigue, dizziness.

digestive: nausea. skin: skin and allergic reactions.

Rare, 1/10000

Hematopsiia: hematopoiia (neutropenia, all bloody hemocytes, leukopenia), anemia.

Instructions on how to handle ADR

Notify the doctor the unwanted effects when using the drug.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindications:

Coldko effervescent tablets 5 Namha Pharm are contraindicated in the following cases:

Patients with hypersensitivity to any ingredients of the drug.

People with liver failure, severe kidney failure.

Men deficiency G6PD.

Patients are treating Mao inhibitors.

Patients with acute asthma attacks.

Be cautious when using

Do not use the same drug with similar ingredients to avoid overdose.

Patients with risk or respiratory decline.

Do not take alcohol when taking the drug because alcohol increases the sedative effects of chlorpheniramin maleat and increases the toxicity of the liver of paracetamol.

It is necessary to warn the patient about signs of serious skin reactions such as Steven-Johnson syndrome (SJS), toxic skin necrosis syndrome (Ten), or Lyell syndrome, acute overseas acne syndrome (AGEP).

Clorpheniramin may increase the risk of urination due to anti -acetylcholine secretions of the drug, especially people with prostate hypertrophy, urinary tract, pyloric gaster, and worsen in people with myasthenia gravis. There is a risk of tooth decay in patients for long -term treatment due to anti -secretion effects Acetylcholine causing dry mouth.

Avoid for people with glaucoma like glaucoma.

Use medication carefully with the elderly (> 60 years old) because these people often increase sensitivity to anti -secretion effects Acetylcholine.

People with coughs have too much phlegm and chronic cough in smokers, asthma or air overflow.

Patients with risk or respiratory decline.

Using dextromethorphan is related to histamine release and should be cautious with children with allergies.

Abuse and dependence on dextromethorphan may occur (though rare), especially due to prolonged high doses.

The ability to drive and operate machinery

The drug can cause drowsiness, dizziness, dizziness, blurred vision and mental impairment in some patients and can seriously affect the ability to drive and operate machinery.

Pregnancy

Avoid for pregnant women. When used, you must consult your doctor.

Breastfeeding period

Avoid for women to breastfeed. When used, you must consult your doctor.

Interactive drug

should not take alcohol when taking the drug because alcohol increases the nervous effect.

Do not coordinate with imao

Storage

Store in a cool place below 300C.

Other drugs

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