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                    ºê·ÐÄÉ¾îÆ®·ÎŰ  BRONCARE TROCHE[Cetylpyridinium chloride , dextromethorphan phenolphthalinate , potassium guajacol sufonate]  
                    
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	      FDA : Cµî±Þ 
				        
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    | µ¶¼ºÁ¤º¸ | 
    Dextromethorphan¿¡ ´ëÇÑ µ¶¼ºÁ¤º¸ : Á¤º¸º¸±â 
Potassium¿¡ ´ëÇÑ µ¶¼ºÁ¤º¸ : Á¤º¸º¸±â 
  Ãâó: ±¹¸³µ¶¼º°úÇпø µ¶¼º¹°ÁúÁ¤º¸DB : http://www.nitr.go.kr/nitr/contents/m134200/view.do  | 
   
  
   
    | Mechanism of Action | 
    
       dextromethorphan¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Dextromethorphan is an opioid-like drug that binds to and acts as antagonist to the NMDA glutamatergic receptor, it is an agonist to the opioid sigma 1 and sigma 2 receptors, it is also an alpha3/beta4 nicotinic receptor antagonist and targets the serotonin reuptake pump. Dextromethorphan is rapidly absorbed from the gastrointestinal tract, where it enters the bloodstream and crosses the blood-brain barrier. The first-pass through the hepatic portal vein results in some of the drug being metabolized into an active metabolite of dextromethorphan, dextrorphan, the 3-hydroxy derivative of dextromethorphan.
  potassium¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Potassium is the major cation (positive ion) inside animal cells, while sodium is the major cation outside animal cells. The concentration differences of these charged particles causes a difference in electric potential between the inside and outside of cells, known as the membrane potential. The balance between potassium and sodium is maintained by ion pumps in the cell membrane. The cell membrane potential created by potassium and sodium ions allows the cell generate an action potential?”a "spike" of electrical discharge. The ability of cells to produce electrical discharge is critical for body functions such as neurotransmission, muscle contraction, and heart function. Potassium is also an essential mineral needed to regulate water balance, blood pressure and levels of acidity. 
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    | Pharmacology | 
     
       dextromethorphan¿¡ ´ëÇÑ Pharmacology Á¤º¸ Dextromethorphan suppresses the cough reflex by a direct action on the cough center in the medulla of the brain. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity.
  potassium¿¡ ´ëÇÑ Pharmacology Á¤º¸ Not Available 
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    | Absorption | 
    
       dextromethorphan¿¡ ´ëÇÑ Absorption Á¤º¸ Rapidly absorbed from the gastrointestinal tract.
  potassium¿¡ ´ëÇÑ Absorption Á¤º¸ Not Available 
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    | Pharmacokinetics | 
    
       Cetylpyridinium chlorideÀÇ ¾à¹°µ¿·ÂÇÐÀÚ·á 
- pubmed¿¡ µ¿¹°½ÇÇèÀº ÀÖÀ¸³ª clinical research´Â ãÀ»¼ö ¾ø¾úÀ½
 
   
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    | Toxicity | 
    
       dextromethorphan¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available
  potassium¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available 
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    | Drug Interactions | 
    
       dextromethorphan¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Dihydroquinidine barbiturate	Quinidine increases the toxicity of dextromethorphanQuinidine	Quinidine increases the toxicity of dextromethorphanQuinidine barbiturate	Quinidine increases the toxicity of dextromethorphanFluoxetine	Combination associated with possible serotoninergic syndromeIsocarboxazid	Possible severe adverse reactionMemantine	Increased risk of CNS adverse effectsMoclobemide	Increased CNS toxicityParoxetine	Combination associated with possible serotoninergic syndromePhenelzine	Possible severe adverse reactionRasagiline	Possible severe adverse reactionSelegiline	Combination associated with possible serotoninergic syndromeSibutramine	Combination associated with possible serotoninergic syndromeTerbinafine	Terbinafine increases dextromethorphan levelsTranylcypromine	Possible severe adverse reaction
  potassium¿¡ ´ëÇÑ Drug_Interactions Á¤º¸ Amiloride	Increased risk of hyperkaliemiaBenazepril	Increased risk of hyperkaliemiaCandesartan	Increased risk of hyperkaliemiaCaptopril	Increased risk of hyperkaliemiaCilazapril	Increased risk of hyperkaliemiaDrospirenone	Increased risk of hyperkaliemiaEnalapril	Increased risk of hyperkaliemiaEplerenone	This association presents an increased risk of hyperkaliemiaEprosartan	Increased risk of hyperkaliemiaForasartan	Increased risk of hyperkaliemiaFosinopril	Increased risk of hyperkaliemiaIrbesartan	Increased risk of hyperkaliemiaLisinopril	Increased risk of hyperkaliemiaLosartan	Increased risk of hyperkaliemiaMoexipril	Increased risk of hyperkaliemiaPerindopril	Increased risk of hyperkaliemiaPolystyrene sulfonate	Antagonism of actionQuinapril	Increased risk of hyperkaliemiaRamipril	Increased risk of hyperkaliemiaSaprisartan	Increased risk of hyperkaliemiaSpirapril	Increased risk of hyperkaliemiaSpironolactone	Increased risk of hyperkaliemiaTasosartan	Increased risk of hyperkaliemiaTelmisartan	Increased risk of hyperkaliemiaTrandolapril	Increased risk of hyperkaliemiaTriamterene	Increased risk of hyperkaliemiaValsartan	Increased risk of hyperkaliemia 
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    CYP450  Drug Interaction | 
    
      [CYP450 TableÁ÷Á¢Á¶È¸] dextromethorphan¿¡ ´ëÇÑ P450 table
  SUBSTRATES 
CYP 2D6 
Beta Blockers: 
S-metoprolol 
propafenone 
timolol 
Antidepressants: 
amitriptyline 
clomipramine 
desipramine 
imipramine 
paroxetine 
Antipsychotics: 
haloperidol 
risperidone 
thioridazine 
aripiprazole 
codeine 
**dextromethorphan** 
duloxetine 
flecainide 
mexiletine 
ondansetron 
tamoxifen 
tramadol 
venlafaxine 
 INHIBITORS 
CYP 2D6 
amiodarone 
buproprion 
chlorpheniramine 
cimetidine 
clomipramine 
duloxetine 
fluoxetine 
haloperidol 
methadone 
mibefradil 
paroxetine 
quinidine 
ritonavir 
 INDUCERS 
CYP 2D6 
N/A 
 
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    | Drug Target | 
    
      
      [Drug Target]
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    | SNP Á¤º¸ | 
    
      Name:Dextromethorphan (DB00514)
 Interacting Gene/Enzyme:Cytochrome P450 2D6 (Gene symbol = CYP2D6) Swissprot P10635
 SNP(s):CYP2D6*6 rs5030655 (T deletion, homozygote)
 Effect:Poor drug metabolizer, lower dose requirements
 Reference(s):Bradford LD, Gaedigk A, Leeder JS: High frequency of CYP2D6 poor and "intermediate" metabolizers in black populations: a review and preliminary data. Psychopharmacol Bull. 1998;34(4):797-804. [PubMed] 
     | 
   
  
   
    | Description | 
    
       dextromethorphan¿¡ ´ëÇÑ Description Á¤º¸ The d-isomer of the codeine analog of levorphanol. Dextromethorphan shows high affinity binding to several regions of the brain, including the medullary cough center. This compound is an NMDA receptor antagonist (receptors, N-methyl-D-aspartate) and acts as a non-competitive channel blocker. It is one of the widely used antitussives, and is also used to study the involvement of glutamate receptors in neurotoxicity. [PubChem]
  potassium¿¡ ´ëÇÑ Description Á¤º¸ Potassium is the major cation (positive ion) inside animal cells, while sodium is the major cation outside animal cells. The concentration differences of these charged particles causes a difference in electric potential between the inside and outside of cells, known as the membrane potential. The balance between potassium and sodium is maintained by ion pumps in the cell membrane. The cell membrane potential created by potassium and sodium ions allows the cell generate an action potential?”a "spike" of electrical discharge. The ability of cells to produce electrical discharge is critical for body functions such as neurotransmission, muscle contraction, and heart function. Potassium is also an essential mineral needed to regulate water balance, blood pressure and levels of acidity. 
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    | Dosage Form | 
    
       dextromethorphan¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Capsule	OralLiquid	OralLozenge	OralStrip	OralSuspension	OralSyrup	OralTablet	Oral
  potassium¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Aerosol	OralCapsule	OralCapsule, extended release	OralElixir	OralLiquid	IntravenousLiquid	OralLiquid	SublingualPowder	OralPowder, for solution	OralSolution	IntravenousSolution	OralSolution / drops	OralTablet	OralTablet, extended release	Oral 
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    | Drug Category | 
    
       dextromethorphan¿¡ ´ëÇÑ Drug_Category Á¤º¸ Analgesics, OpioidAntitussive AgentsExcitatory Amino Acid Antagonists 
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    | Smiles String Canonical | 
    
       dextromethorphan¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ COC1=CC2=C(CC3C4CCCCC24CCN3C)C=C1
  potassium¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ Not Available 
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    | Smiles String Isomeric | 
    
       dextromethorphan¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ COC1=CC2=C(C[C@H]3[C@H]4CCCC[C@@]24CCN3C)C=C1
  potassium¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ Not Available 
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    | InChI Identifier | 
    
       dextromethorphan¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C18H25NO/c1-19-10-9-18-8-4-3-5-15(18)17(19)11-13-6-7-14(20-2)12-16(13)18/h6-7,12,15,17H,3-5,8-11H2,1-2H3/t15-,17+,18-/m1/s1
  potassium¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ Not Available 
     | 
   
  
   
    | Chemical IUPAC Name | 
    
       dextromethorphan¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ Not Available
  potassium¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ Not Available 
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