Dr. Xiehe said ｜ Is it hard to find a bottle of cough-relieving weapon brown ammonium mixture？ Pharmacists say reasonable application is safe!
In the cold weather, respiratory diseases blessed by COVID-19 have made more and more people suffer from "cough". When everyone is suffering from cough, a "star potion" made by Peking Union Medical College Hospital is very popular. It is brown ammonium mixture (now known as compound ammonium chloride and licorice oral solution). Although the mixture of ammonium brown is good, as a medicine, it needs to be used reasonably in order to play its role to the greatest extent under the premise of ensuring safety. Today, the pharmacist team of Peking Union Medical College Hospital will give you a detailed explanation-
Q: What is the brown ammonium mixture? Is it Chinese medicine or western medicine? Where can I buy it?
A:Brown ammonium mixture is a preparation made of ammonium chloride and compound licorice oral solution through a certain production process, which is used to treat cough and uncomfortable cough caused by upper respiratory tract infection, bronchial infection and cold.
The approved preparation category of brown ammonium mixture produced by Peking Union Medical College Hospital is chemical preparation, that is, western medicine in the traditional sense. According to the relevant regulations of the state, preparations of medical institutions can only be used by prescription in our hospital.
Tips: Medical institution preparation refers to the fixed prescription preparation prepared and used by medical institutions for their own use according to the clinical needs of their own units.
Preparations of medical institutions can only be used in this medical institution with the prescription of medical practitioners or assistant medical practitioners, and are consistent with the scope of diagnosis and treatment specified in the Practice License of Medical Institutions, and may not be sold in the market or in disguised form.
Q: What’s special about the self-made brown ammonium mixture of Peking Union Medical College Hospital? Is safety and effectiveness guaranteed?
A: Brown ammonium mixture is a classic preparation widely used in clinic. It was first recorded on page 307 of Preparation Compilation of Capital Hospital in 1982.
According to the pharmacological characteristics of ammonium chloride, the senior pharmacists of Peking Union Medical College Hospital specially optimized the content of ammonium chloride in the prescription from the beginning of development in order to reduce the adverse reactions such as nausea and vomiting that may be caused by patients taking it, and it has been used ever since.
The preparation room of the pharmacy department of Peking Union Medical College Hospital strictly abides by the "Management Standard for Preparation of Medical Institutions" in the production process, and the drug inspection room conducts chemical and microbial limit tests according to the quality standards attached to the latest approval in 2021 and the requirements of the 2020 edition of China Pharmacopoeia. The quality of each bottle of ammonium brown mixture is reliably guaranteed.
Q: Under what circumstances can the mixture of ammonium brown be used?
A:Brown ammonium mixture is a compound preparation, and its main components are ammonium chloride (expectorant), glycyrrhizic acid (expectorant), camphor (expectorant), anhydrous morphine (antitussive and analgesic) and guaifenesin (expectorant). It is a symptomatic relief agent. Therefore, when patients have acute cough that affects their normal life and rest, and sticky phlegm is not easy to cough up, they can be used to relieve cough and eliminate phlegm.
Routine usage and dosage is 10ml orally three times a day. At the same time, it should be noted that the ingredients in the preparation are complex and contain opium tincture and ethanol, so how to use it safely and reasonably-
In order to use the ammonium brown mixture safely and reasonably, we should first pay attention to its main components:
1. Ammonium chloride: expectorant, which can chemically stimulate gastric mucosa, cause mild nausea, reflexively increase the secretion of trachea and bronchial glands, increase the amount of sputum, make sputum easy to cough up, and facilitate the removal of sticky phlegm that is not easy to cough up. After absorption, it enters blood and extracellular fluid, making urine acidic.
2. Compound Glycyrrhiza Oral Solution: It is recorded in China Pharmacopoeia (2020 Edition) Part II. The main components are Glycyrrhiza Liquid Extract, Compound Camphor Tincture and Guaifenesin, and the auxiliary materials are glycerol and concentrated ammonia solution (to keep the preparation stable and prevent precipitation). The main component of Glycyrrhiza uralensis Fisch. Fluid extract is glycyrrhizic acid (containing 20%~25% ethanol at the same time), which is the sweet source of brown ammonium mixture and a protective expectorant, and has a certain effect of moistening throat. Compound camphor tincture contains camphor, opium tincture (containing 1% anhydrous morphine), anise oil, benzoic acid and about 56% ethanol, in which camphor has stimulating and expectorant effects, opium tincture has cough relieving and certain analgesic effects, anise oil mainly plays a flavoring role, and benzoic acid is used as a preservative; Guaifenesin is a stimulating expectorant, which reflexively causes the secretion of bronchial mucosa glands to increase, reduces the viscosity of sputum and makes sticky sputum easy to cough up.
Q: Under what circumstances can’t the mixture of brown ammonium be used?
A:1. Those who are allergic to any component of this product are prohibited.
2. Infants, pregnant and lactating women are prohibited.
3. Ammonium chloride, the main component, can increase the blood ammonia concentration. It is forbidden for patients with severe liver and renal insufficiency and patients with metabolic alkalosis caused by vomiting. Excessive or long-term use can easily lead to hyperchloric acidosis, and patients with metabolic acidosis are forbidden.
4. Glycyrrhizic acid has a corticosteroid-like effect. Long-term and large-scale application may cause water and sodium retention and hypokalemia, and increase the risk of hypertension and heart damage. It is forbidden for patients with end-stage liver cirrhosis who are difficult to control aldosteronism, myopathy, hypokalemia and have a tendency to increase blood ammonia.
5. Camphor monoxide, the metabolite of compound camphor tincture in vivo, has obvious cardiotonic, pressor and respiratory excitation effects, and is prohibited for patients with severe pulmonary heart disease and hyperthyroidism.
6. Because of the stimulating and dilating effects of guaifenesin on vascular smooth muscle, it is forbidden for patients with pulmonary hemorrhage.
Q: Which groups need to be used with caution?
A:1. Children: It must be used under adult supervision. Please consult a doctor or pharmacist for specific dosage.
2, the elderly: slow metabolism, poor tolerance to such drugs, be sure to strictly follow the doctor’s advice when using.
3. Due to the stimulating effect of ammonium chloride and other ingredients on the digestive tract, patients with digestive tract diseases such as gastritis and peptic ulcer should use it with caution.
4. This product contains compound camphor tincture and various expectorants. It should be used with caution in severe bronchial asthma and acute attack of chronic obstructive pulmonary disease (COPD), and in patients with respiratory depression.
5. Patients with angina pectoris and arteriosclerosis should use it with caution, and patients with hypertension should pay attention to detecting blood pressure during taking it.
6, glaucoma, prostate hypertrophy patients with caution.
Q: What other precautions are there?
A:1. Taking after meals: Taking after meals can reduce the irritation of the mixture of brown ammonium to the gastrointestinal mucosa, and help to reduce the adverse reactions of the gastrointestinal tract.
2. Avoid taking the same medicine: Don’t take drugs containing licorice ingredients such as licorice tablets and compound licorice oral solution at the same time, so as to avoid increasing the risk of poisoning, and pay attention to avoiding taking other powerful antitussive drugs.
3. Alcohol: The alcohol content in the brown ammonium mixture is not less than 9.5%(v/v), so it is necessary to pay attention to not operating machinery and driving vehicles after taking this product; At the same time, cephalosporins or other drugs that interact with alcohol should be avoided.
4. Athletes should use it with caution: this product contains opium tincture. Although the content of morphine is only 0.009%, which is not within the scope of narcotic drugs management, athletes still need to be reminded to use it with caution; At the same time, in order to avoid possible addiction, clinical attention should be paid to avoiding long-term or large-scale use.
5. If you are taking other medicines, please consult a doctor or pharmacist before using this product.