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                    ¾Ó¶ìÄÚǪݼ¿  [Carbinoxamine Maleate , Dextromethorphan HBr , Methylephedrine HCl , Noscapine , Potassium guaiacol sulfonate]  
                    
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	 °í½ÃµÈ º´¿ë±Ý±â ³»¿ëÀº ¾ø½À´Ï´Ù.
	 
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    | µ¶¼ºÁ¤º¸ | 
    Dextromethorphan¿¡ ´ëÇÑ µ¶¼ºÁ¤º¸ : Á¤º¸º¸±â 
Ephedrine¿¡ ´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 | 
    
       Carbinoxamine¿¡ ´ëÇÑ Mechanism_Of_Action Á¤º¸ Carbinoxamine competes with free histamine for binding at HA-receptor sites. This antagonizes the effects of histamine on HA-receptors, leading to a reduction of the negative symptoms brought on by histamine HA-receptor binding. Carbinoxamine's anticholinergic action appears to be due to a central antimuscarinic effect, which also may be responsible for its antiemetic effects, although the exact mechanism is unknown.
  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 | 
     
       Carbinoxamine¿¡ ´ëÇÑ Pharmacology Á¤º¸ Carbinoxamine is an antihistamine of the ethanolamine class. Ethanolamine antihistamines have significant antimuscarinic activity and produce marked sedation in most patients. In addition to the usual allergic symptoms, the drug also treats irritant cough and nausea, vomiting, and vertigo associated with motion sickness. It also is used commonly to treat drug-induced extrapyramidal symptoms as well as to treat mild cases of Parkinson's disease. Rather than preventing the release of histamine, as do cromolyn and nedocromil, carbinoxamine competes with free histamine for binding at HA-receptor sites. Carbinoxamine competitively antagonizes the effects of histamine on HA-receptors in the GI tract, uterus, large blood vessels, and bronchial muscle. Ethanolamine derivatives have greater anticholinergic activity than do other antihistamines, which probably accounts for the antidyskinetic action of carbinoxamine.
  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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    | Metabolism | 
    
       Dextromethorphan¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Cytochrome P450 2D6 (CYP2D6)
  Potassium¿¡ ´ëÇÑ Metabolism Á¤º¸ # Phase_1_Metabolizing_Enzyme:Cytochrome P450 11B2 (CYP11B2) 
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    | Half-life | 
    
       Carbinoxamine¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ 10 to 20 hours
  Dextromethorphan¿¡ ´ëÇÑ ¹Ý°¨±â Á¤º¸ 3-6 hours 
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    | Absorption | 
    
       Dextromethorphan¿¡ ´ëÇÑ Absorption Á¤º¸ Rapidly absorbed from the gastrointestinal tract.
  Potassium¿¡ ´ëÇÑ Absorption Á¤º¸ Not Available 
     | 
   
  
   
    | Pharmacokinetics | 
    
       Dextromethorphan HBrÀÇ ¾à¹°µ¿·ÂÇÐÀÚ·á 
	- ÁøÇØÀÛ¿ë ¹ßÇö½Ã°£ : 15~30ºÐ À̳»
	
 - ÀÛ¿ëÁö¼Ó½Ã°£ : 6½Ã°£±îÁö
	
 - ´ë»ç : °£´ë»ç
	
 - ¼Ò½Ç : ÁÖ·Î ½Å¹è¼³
  
 Carbinoxamine MaleateÀÇ ¾à¹°µ¿·ÂÇÐÀÚ·á 
- ÀÛ¿ëÁö¼Ó½Ã°£ : 3-6 ½Ã°£
 - ¹Ý°¨±â : 10-20 ½Ã°£
  
     | 
   
  
   
    | Biotransformation | 
    
       Dextromethorphan¿¡ ´ëÇÑ Biotransformation Á¤º¸ Hepatic. Rapidly and extensively metabolized to dextrorphan (active metabolite). One well known metabolic catalyst involved is a specific cytochrome P450 enzyme known as 2D6, or CYP2D6. 
     | 
   
  
   
    | Toxicity | 
    
       Dextromethorphan¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available
  Potassium¿¡ ´ëÇÑ Toxicity Á¤º¸ Not Available 
     | 
   
  
   
    | 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 
     | 
   
  
   
    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 
 
     | 
   
  
   
    | Food Interaction | 
    
       Potassium¿¡ ´ëÇÑ Food Interaction Á¤º¸ Not Available 
     | 
   
  
   
    | Drug Target | 
    
      
      [Drug Target]
     | 
   
  
   
    | 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] 
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    | Description | 
    
       Carbinoxamine¿¡ ´ëÇÑ Description Á¤º¸ Carbinoxamine competes with free histamine for binding at HA-receptor sites. This antagonizes the effects of histamine on HA-receptors, leading to a reduction of the negative symptoms brought on by histamine HA-receptor binding. In addition to the usual allergic symptoms, the drug also treats irritant cough and nausea, vomiting, and vertigo associated with motion sickness. Carbinoxamine's anticholinergic action appears to be due to a central antimuscarinic effect, which also may be responsible for its antiemetic effects, although the exact mechanism is unknown. It also is used commonly to treat drug-induced extrapyramidal symptoms as well as to treat mild cases of Parkinson's disease.
  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 | 
    
       Carbinoxamine¿¡ ´ëÇÑ Dosage_Form Á¤º¸ Solution / drops	OralSyrup	OralTablet	OralTablet, extended release	Oral
  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 | 
    
       Carbinoxamine¿¡ ´ëÇÑ Drug_Category Á¤º¸ Antihistamines
  Dextromethorphan¿¡ ´ëÇÑ Drug_Category Á¤º¸ Analgesics, OpioidAntitussive AgentsExcitatory Amino Acid Antagonists 
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    | Smiles String Canonical | 
    
       Carbinoxamine¿¡ ´ëÇÑ Smiles_String_canonical Á¤º¸ CN(C)CCOC(C1=CC=C(Cl)C=C1)C1=CC=CC=N1
  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 | 
    
       Carbinoxamine¿¡ ´ëÇÑ Smiles_String_isomeric Á¤º¸ CN(C)CCO[C@@H](C1=CC=C(Cl)C=C1)C1=CC=CC=N1
  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 | 
    
       Carbinoxamine¿¡ ´ëÇÑ InChI_Identifier Á¤º¸ InChI=1/C16H19ClN2O/c1-19(2)11-12-20-16(15-5-3-4-10-18-15)13-6-8-14(17)9-7-13/h3-10,16H,11-12H2,1-2H3
  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 
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    | Chemical IUPAC Name | 
    
       Carbinoxamine¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ 2-[(4-chlorophenyl)-pyridin-2-ylmethoxy]-N,N-dimethylethanamine
  Dextromethorphan¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ Not Available
  Potassium¿¡ ´ëÇÑ Chemical_IUPAC_Name Á¤º¸ Not Available 
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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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