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                    ÄÚ¶Ñ¿¡À̽÷´  COTTU-A SYRUP[Brompheniramine Maleate , Phenylephrine HCl , Phenylpropanolamine HCl]  
                    
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                     ÀϹÝÀǾàǰ | »èÁ¦  
                        
                    	
                    
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    141  (Ç×È÷½ºÅ¸¹ÎÁ¦                                                    )
      
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    | Mechanism of Action | 
    
       Brompheniramine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Brompheniramine works by acting as an antagonist of the H1 histamine receptors. It also functions as a moderately effective anticholingeric agent, likely an antimuscarinic agent similar to other common antihistamines such as diphenhydramine. Its effects on the cholinergic system may include side-effects such as drowsiness, sedation, dry mouth, dry throat, blurred vision, and increased heart rate.
  Phenylephrine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Phenylephrine produces its ophthalmic and systemic actions by acting on alpha 1 adrenergic receptors in the pupillary dilator muscle and the vascular smooth musle, resulting in contraction of the dilator muscle and contraction of the smooth muscle in the arterioles of the conjunctiva and peripheral vasoconstriction. Phenylephrine decreases nasal congestion by acting on alpha 1 adrenergic receptors in the arterioles of the nasal mucosa to produce constriction.
  Phenylpropanolamine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Phenylpropanolamine acts directly on alpha- and, to a lesser degree, beta-adrenergic receptors in the mucosa of the respiratory tract. Stimulation of alpha-adrenergic receptors produces vasoconstriction, reduces tissue hyperemia, edema, and nasal congestion, and increases nasal airway patency. PPA indirectly stimulates beta-receptors, producing tachycardia and a positive inotropic effect. 
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    | Pharmacology | 
     
       Brompheniramine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Brompheniramine is an antihistaminergic medication of the propylamine class. It is a first-generation antihistamine. In allergic reactions an allergen interacts with and cross-links surface IgE antibodies on mast cells and basophils. Once the mast cell-antibody-antigen complex is formed, a complex series of events occurs that eventually leads to cell-degranulation and the release of histamine (and other chemical mediators) from the mast cell or basophil. Once released, histamine can react with local or widespread tissues through histamine receptors. Histamine, acting on H1-receptors, produces pruritis, vasodilatation, hypotension, flushing, headache, tachycardia, and bronchoconstriction. Histamine also increases vascular permeability and potentiates pain. Brompheniramine is a histamine H1 antagonist (or more correctly, an inverse histamine agonist) of the alkylamine class. It provides effective, temporary relief of sneezing, watery and itchy eyes, and runny nose due to hay fever and other upper respiratory allergies.
  Phenylephrine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Phenylephrine is a powerful vasoconstrictor. It is used as a mydriatic, nasal decongestant, and cardiotonic agent. Phenylephrine is a postsynaptic alpha-receptor stimulant with little effect on the beta receptors of the heart. Parenteral administration of Phenylephrine causes a rise in systolic and diastolic pressures, cardiac output is slightly decreased and peripheral resistance is considerably increased, most vascular beds are constricted; renal, splanchnic, cutaneous, and limb blood flows are reduced but coronary blood flow is increased. Pulmonary vessels are constricted, and pulmonary arterial pressure is raised. This alpha receptor sympathetic agonist is also used locally because its vasoconstrictor and mydriatic action.
  Phenylpropanolamine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Phenylpropanolamine (PPA), a sympathomimetic agent structurally similar to pseudoephedrine, is used to treat nasal congestion. Phenylpropanolamine is found in appetite suppressant formulations and with guaifenesinin in cough-cold formulations. In 2000, the FDA requested that all drug companies discontinue marketing products containing phenylpropanolamine, due to an increased risk of hemorrhagic stroke in women who used phenylpropanolamine. 
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    | Metabolism | 
    
       Brompheniramine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Not Available
  Phenylephrine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Monoamine oxidase type A (MAO-A)
  Phenylpropanolamine¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Monoamine oxidase type A (MAO-A) 
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    | Protein Binding | 
    
       Brompheniramine¿¡ ´ëÇÑ ´Ü¹é°áÇÕ Á¤º¸ Not Available
  Phenylephrine¿¡ ´ëÇÑ ´Ü¹é°áÇÕ Á¤º¸ 95% binding-plasma proteins
  Phenylpropanolamine¿¡ ´ëÇÑ ´Ü¹é°áÇÕ Á¤º¸ Not Available 
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    | Half-life | 
    
       Brompheniramine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ Not Available
  Phenylephrine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ 2.1 to 3.4 hours
  Phenylpropanolamine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ 2.1 to 3.4 hours. 
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    | Absorption | 
    
       Brompheniramine¿¡ ´ëÇÑ Absorption Á¤º¸ Antihistamines are well absorbed from the gastrointestinal tract after oral administration.
  Phenylephrine¿¡ ´ëÇÑ Absorption Á¤º¸ Reduced bioavailability (compared to pseudoephedrine) following oral administration due to significant first-pass metabolism.
  Phenylpropanolamine¿¡ ´ëÇÑ Absorption Á¤º¸ Reduced bioavailability (about 38%) from gastrointestinal tract because of first pass metabolism by monoamine oxidase in the stomach and liver. 
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    | Pharmacokinetics | 
    
       Brompheniramine MaleateÀÇ ¾à¹°µ¿·ÂÇÐÀÚ·á 
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    | Biotransformation | 
    
       Brompheniramine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic (cytochrome P-450 system), some renal.
  Phenylephrine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Oral phenylephrine is extensively metabolised by monoamine oxidase, an enzyme which is present in the stomach and liver.
  Phenylpropanolamine¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic 
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    | Toxicity | 
    
       Brompheniramine¿¡ ´ëÇÑ Toxicity Á¤º¸ Oral, rat: LD50 = 318 mg/kg. Signs of overdose include fast or irregular heartbeat, mental or mood changes, tightness in the chest, and unusual tiredness or weakness.
  Phenylephrine¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available
  Phenylpropanolamine¿¡ ´ëÇÑ Toxicity Á¤º¸ May induce ventricular extrasystoles and short paroxysms of ventricular tachycardia, a sensation of fullness in the head and tingling of the extremities; LD50=1490mg/kg (orally in rat) 
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    | Drug Interactions | 
    
       Brompheniramine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Donepezil	Possible antagonism of actionGalantamine	Possible antagonism of actionRivastigmine	Possible antagonism of action
  Phenylephrine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Alseroxylon	Increased arterial pressureIsocarboxazid	Increased arterial pressureDeserpidine	Increased arterial pressureGuanethidine	The agent decreases the effect of guanethidineRasagiline	Increased arterial pressureMethyldopa	Increased arterial pressureMidodrine	Increased arterial pressurePargyline	Increased arterial pressurePhenelzine	Increased arterial pressureReserpine	Increased arterial pressureTranylcypromine	Increased arterial pressureOxytocin	Possible marked increase of arterial pressureMethylergonovine	Possible marked increase of arterial pressureLinezolid	Possible increase of arterial pressureErgonovine	Possible marked increase of arterial pressureTrimipramine	The tricyclic increases the sympathomimetic effectProtriptyline	The tricyclic increases the sympathomimetic effectNortriptyline	The tricyclic increases the sympathomimetic effectClomipramine	The tricyclic increases the sympathomimetic effectAmitriptyline	The tricyclic increases the sympathomimetic effectAmoxapine	The tricyclic increases the sympathomimetic effectDesipramine	The tricyclic increases the sympathomimetic effectDoxepin	The tricyclic increases the sympathomimetic effectImipramine	The tricyclic increases the sympathomimetic effectMoclobemide	Moclobemide increases the sympathomimetic effect
  Phenylpropanolamine¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Acetophenazine	Decreased anorexic effect, may increase psychotic symptomsChlorpromazine	Decreased anorexic effect, may increase psychotic symptomsEthopropazine	Decreased anorexic effect, may increase psychotic symptomsFluphenazine	Decreased anorexic effect, may increase psychotic symptomsMethotrimeprazine	Decreased anorexic effect, may increase psychotic symptomsGuanethidine	The agent decreases the effect of guanethidineMesoridazine	Decreased anorexic effect, may increase psychotic symptomsThioridazine	Decreased anorexic effect, may increase psychotic symptomsMethdilazine	Decreased anorexic effect, may increase psychotic symptomsTrimeprazine	Decreased anorexic effect, may increase psychotic symptomsPropericiazine	Decreased anorexic effect, may increase psychotic symptomsPerphenazine	Decreased anorexic effect, may increase psychotic symptomsProchlorperazine	Decreased anorexic effect, may increase psychotic symptomsPromazine	Decreased anorexic effect, may increase psychotic symptomsPromethazine	Decreased anorexic effect, may increase psychotic symptomsPropiomazine	Decreased anorexic effect, may increase psychotic symptomsThiethylperazine	Decreased anorexic effect, may increase psychotic symptomsTrifluoperazine	Decreased anorexic effect, may increase psychotic symptomsTriflupromazine	Decreased anorexic effect, may increase psychotic symptomsMoclobemide	Moclobemide increases the sympathomimetic effectAmitriptyline	The tricyclic increases the sympathomimetic effectAmoxapine	The tricyclic increases the sympathomimetic effectBromocriptine	The sympathomimetic increases the toxicity of bromocriptineClomipramine	The tricyclic increases the sympathomimetic effectDesipramine	The tricyclic increases the sympathomimetic effectDoxepin	The tricyclic increases the sympathomimetic effectImipramine	The tricyclic increases the sympathomimetic effectNortriptyline	The tricyclic increases the sympathomimetic effectProtriptyline	The tricyclic increases the sympathomimetic effectTrimipramine	The tricyclic increases the sympathomimetic effectVenlafaxine	Risk of serotoninergic syndromeFluvoxamine	Risk of serotoninergic syndromeParoxetine	Risk of serotoninergic syndromeFluoxetine	Risk of serotoninergic syndromeAlseroxylon	Increased arterial pressureDeserpidine	Increased arterial pressureIsocarboxazid	Increased arterial pressureLinezolid	Possible increase of arterial pressureTranylcypromine	Increased arterial pressureRasagiline	Increased arterial pressureReserpine	Increased arterial pressurePhenelzine	Increased arterial pressurePargyline	Increased arterial pressureMethyldopa	Increased arterial pressureMidodrine	Increased arterial pressure 
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    CYP450  Drug Interaction | 
    
      [CYP450 TableÁ÷Á¢Á¶È¸] 
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    | Food Interaction | 
    
       Brompheniramine¿¡ ´ëÇÑ Food Interaction Á¤º¸ Take with food.Avoid alcohol.
  Phenylephrine¿¡ ´ëÇÑ Food Interaction Á¤º¸ Take without regard to meals.
  Phenylpropanolamine¿¡ ´ëÇÑ Food Interaction Á¤º¸ Take without regard to meals.Limit caffeine intake. 
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    | Drug Target | 
    
      
      [Drug Target]
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    | Description | 
    
       Brompheniramine¿¡ ´ëÇÑ Description Á¤º¸ Histamine H1 antagonist used in treatment of allergies, rhinitis, and urticaria. [PubChem]
  Phenylephrine¿¡ ´ëÇÑ Description Á¤º¸ An alpha-adrenergic agonist used as a mydriatic, nasal decongestant, and cardiotonic agent. [PubChem]
  Phenylpropanolamine¿¡ ´ëÇÑ Description Á¤º¸ Phenylpropanolamine has been withdrawn in Canada. In November 2000, the Food and Drug Administration (FDA) issued a public health advisory against the use of the drug. 
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    | Dosage Form | 
    
       Brompheniramine¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Not Available
  Phenylephrine¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Liquid	IntramuscularLiquid	IntravenousLiquid	OphthalmicOintment	TopicalSolution	IntravenousSolution / drops	OphthalmicStrip	OralTablet	Oral
  Phenylpropanolamine¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Not Available 
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    | Drug Category | 
    
       Brompheniramine¿¡ ´ëÇÑ Drug_Category Á¤º¸ Anti-Allergic AgentsHistamine H1 Antagonists
  Phenylephrine¿¡ ´ëÇÑ Drug_Category Á¤º¸ Adrenergic alpha-AgonistsCardiotonic AgentsMydriaticsNasal DecongestantsSympathomimeticsVasoconstrictor Agents
  Phenylpropanolamine¿¡ ´ëÇÑ Drug_Category Á¤º¸ Adrenergic alpha-AgonistsAppetite DepressantsNasal DecongestantsSympathomimetics 
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    | Smiles String Canonical | 
    
       Brompheniramine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CN(C)CCC(C1=CC=C(Br)C=C1)C1=CC=CC=N1
  Phenylephrine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CNCC(O)C1=CC(O)=CC=C1
  Phenylpropanolamine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CC(N)C(O)C1=CC=CC=C1 
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    | Smiles String Isomeric | 
    
       Brompheniramine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ CN(C)CC[C@H](C1=CC=C(Br)C=C1)C1=CC=CC=N1
  Phenylephrine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ CNC[C@H](O)C1=CC(O)=CC=C1
  Phenylpropanolamine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ C[C@@H](N)[C@@H](O)C1=CC=CC=C1 
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    | InChI Identifier | 
    
       Brompheniramine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C16H19BrN2/c1-19(2)12-10-15(16-5-3-4-11-18-16)13-6-8-14(17)9-7-13/h3-9,11,15H,10,12H2,1-2H3
  Phenylephrine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C9H13NO2/c1-10-6-9(12)7-3-2-4-8(11)5-7/h2-5,9-12H,6H2,1H3/t9-/m0/s1
  Phenylpropanolamine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C9H13NO/c1-7(10)9(11)8-5-3-2-4-6-8/h2-7,9,11H,10H2,1H3/t7-,9-/m1/s1 
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    | Chemical IUPAC Name | 
    
       Brompheniramine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 3-(4-bromophenyl)-N,N-dimethyl-3-pyridin-2-ylpropan-1-amine
  Phenylephrine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 3-[(1R)-1-hydroxy-2-methylaminoethyl]phenol
  Phenylpropanolamine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ (1S,2R)-2-amino-1-phenylpropan-1-ol 
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    | Drug-Induced Toxicity Related Proteins | 
    
      MALEATE ÀÇ Drug-Induced Toxicity Related ProteinÁ¤º¸ Replated Protein:Intercellular adhesion molecule 1  Drug:maleate Toxicity:hepatic injury.  [¹Ù·Î°¡±â] 
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