 | ||
Terpin hydrate is an expectorant, commonly used to loosen mucus in patients presenting with acute or chronic bronchitis, and related conditions. It is derived from sources such as oil of turpentine, oregano, thyme and eucalyptus. It was popular in the United States since the late nineteenth century, but was removed from marketed medications in the 1990s after the U.S. Food and Drug Administration (FDA) found a lack of evidence of effectiveness. Elixirs of terpin hydrate are still available with a prescription, but must be prepared by a compounding pharmacy.
Contents
History
Terpin hydrate was first physiologically investigated by Lepine in 1855. He reported that it acted upon the mucous membranes and also the nervous system in a manner similar to the oil of turpentine.
The following preparations of Terpin hydrate were available in the United States in 1907:
Uses
Terpin hydrate is an expectorant, commonly used in the treatment of acute and chronic bronchitis. It is commonly formulated with an antitussive (e.g., codeine) as a combined preparation.
Pharmacologic mechanisms of action
A humectant and expectorant, terpin hydrate works directly on the bronchial secretory cells in the lower respiratory tract to liquify and facilitate the elimination of bronchial secretions. It also exerts a weak antiseptic effect on the pulmonary parenchyma.
Indications
The preparation is used in acute and chronic bronchitis, pneumonia, bronchiectasis, chronic obstructive pulmonary disease, infectious and inflammatory diseases of the upper respiratory tract.
Adverse effects
Adverse reactions include depression of the respiration, sedation, coordination disorders, constipation, and urinary retention.
Long-term administration of the popular combination product of terpin hydrate with codeine may lead to codeine dependence. Terpin hydrate with codeine is often mixed with alcohol as codeine is not as readily as soluble in water. The high alcohol content (42 percent) may increase CNS depression, codeine metabolism, as well as abuse potential.
Currently available expectorants in the United States
Currently, guaifenesin (glyceryl guaiacolate) is the only FDA approved expectorant in the United States. Besides terpin hydrate, other expectorants lacking evidence of efficacy include ammonium chloride, beechwood creosote, benzoin preparations, camphor, eucalyptol/eucalyptus oil, iodines, ipecac syrup, menthol/peppermint oil, pine tar preparations, potassium guaiacolsulfonate, sodium citrate, squill preparations, tolu and turpentine oil.