Effects Of High Dosage of Codeine - Containing Cough Syrup Administration on Some Biochemical Parameters of Liver in Albino Rats

The study aimed to determine the effect of a high dosage of codeine-containing cough syrup administration on some biochemical parameters of the liver in albino rats. Codeine at 80 mg/kg/day, 160 mg/kg/day, 240 mg/kg/day, 320 mg/kg/day cough syrup were administered orally to albino rats for 21 days, biochemical parameters were analyzed for the activities of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), Alkaline phosphatase (ALP), Bilirubin, Total protein and Albumin. Results obtained revealed that a high dosage of codeine administration significantly increased plasma levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), bilirubin and albumin while it reduced total protein level when compared with the control rats. The study confirmed the risk of increased hepatotoxicity due to a high dosage of codeine administration. Although codeine is reported to be effective in pain management, its toxicity should be kept in mind.

The Effect of High Dosage of Codeine-Containing Cough Syrup on Renal Function on Albino Rats

Codeine-containing cough syrup (CCS) is one of the most abused drugs in the world especially among the youths. However, there is need to study the nephrotoxic effect associated with oral administration of the drug and to ascertain its effect on the kidney. Consequently, understanding the renal abnormalities in chronic use of CCS will be crucial for effective development of interventions. This study assessed the nephrotoxic effect associated with oral administration of codeine-containing cough syrup (Tutolin with Codeine) in albino rats, using the level of creatinine, urea, sodium, potassium and chloride ions as biomarker in the serum of albino rats. The rats were administered orally with Tutolin and Codeine at a dose of 80mg/kg, 160mg/kg, 240 mg/kg and 320mg/kg body weight. After three weeks of oral administration of the syrup to all the groups, there was no difference (P> 0.05) in the levels of sodium ion, chloride ion and creatinine among all the study groups and levels of urea and potassium ion in the group administered with 80 mg/kg, 160 mg/kg and 240 mg/kg body weight of tutolin with codeine compared with the control. After three weeks of oral administration of 80 mg/kg, 160 mg/kg, 240 mg/kg and 320 mg/kg body weight tutolin with codeine cough syrup, urea and potassium ion concentrations were higher (p<0.05) in group given 320mg/kg body weight of tutolin with codeine cough syrup compared with the control. This suggests that at higher doses, tutolin with codeine containing cough syrup may have effect on the kidney.

Design, Development and Evaluation of Anisomeles indica Herbal Cough Syrup

The objective of the present study was to design, development and evaluation antitussive herbal cough syrup because designing of oral herbal formulation is still a challenge in modern pharmaceutics and the syrup formulation presents many technical problems to the industrial pharmacist. Potential antitussive herbs were used for developing the herbal cough syrup. Decoction of plant Anisomeles indica, Leaves of Adhathoda vasika, stems of Glycyrrhiza glabra, fruits of Piper nigrum and plant of Mentha piperita was prepared. One part of decoction was mixed with five parts of simple syrup IP (1:5) to prepare formulation. The formulations were evaluated by morphological characters, physical parameters like PH, Specific gravity, viscosity etc. Herbal cough syrup was also subjected for the accelerated stability testing (AST) for the period of 72hours at accelerated temperature conditions. No marked changes were noticed in all the evaluated parameters during AST. The laboratory scale preparation of herbal Syrup may be used as a stable, liquid dosage form and the work done in stability testing may help in the progress of shelf-life determination studies. The presence study includes design, development and evaluation of Anisomeles indica herbal cough syrup first time.

Histopathological Effect of Emzolyn Codein Cough Syrup on Lungs and Its Oxidative Stress Biomarkers

Despite the dangers associated with the increased use of codeine drugs, limited researches have addressed the specific effects of emzolyn codeine on the lung. The aim of this study was to assess the histological effects of emzolyn codeine cough syrup on the lung of Wistar rats and its oxidative stress. Twenty one (21) Wistar rats were divided into 3 groups labeled T1, T2 and T3. Group T1 served as control and was given distilled water and diet for 42 days, group T2 was treated with 0.1 mg/g bodyweight emzolyn codeine cough syrup for 21 days while group T3 was treated with 0.1 mg/g bodyweight emzolyn codeine cough syrup for 42 days. At the end of the duration, the wistar rats were sacrificed under anaesthesia and the lungs were collected after dissection and transferred into 10% buffered formalin. Sections of the lungs were obtained and processed for histological studies using Hematoxylin and Eosin stain, Periodic acid Schiff’s solution, Phosphotungstic acid Haematoxylin stain and Methanamine Silver stains. Results from the study suggested that acute and chronic exposure to emzolyn codeine cough syrup produced significant (P<0.05) decrease in body weight, edematous aveolar space with marked type 11 pneumocyte, marked hypertrophy (H) of the septa and marked inflammatory cells. The levels of total antioxidant status (TAS) was also determined using standard spectrophotometric techniques. The mean MDA of the exposed groups were significantly higher while the mean levels of SOD, GPx, CAT, and GSH were significantly lower than the control group. In conclusion, this study confirmed the risk of increased oxidative stress, pulmonary toxicity and decreased body weight due to emzolyn codeine cough syrup administration. Thus, indiscriminately and prolong use emzolyn codeine drug should be avoided and antioxidant supplements are advised as a prophylactic supportive therapy for adequate measures in preventing development of oxidative stress-associated complications among exposed individuals.

Evaluation of the bacteriological status of cough syrup sold in pharmaceutical stores in Owerri, Imo State, Nigeria

This work was aimed at assessing the level and type of bacterial contaminants in cough syrups sold in Owerri, as well as the associated public health implications. Thirty bottled samples of five different brands of cough syrup were purchased and assessed bacteriologically. Ten out of the thirty samples had a satisfactory microbial load, whereas twenty samples exceeded the tolerance limit of permissible micro-organisms (103cfu/ml) specified for syrups. The mean counts obtained ranged from 1x103-1.15x107 (cfu)/ml. Syrup D had the highest bacterial mean value of 1.15x107 cfu/ml, while C had the lowest bacterial mean value of 1x103 cfu/ml. Micrococcus luteus, Bacillus subtlis, Serratia macscense, Escherichia coli, and Staphylococcus aureus were identified as the most predominant contaminants. This level of bacterial load reveals contamination which can be traceable contaminated water and other raw materials used for their preparation, personnel, environment and poor manufacturing practice. This portrays the level of health risks to which the consumers can be exposed. From the results, it can be concluded that majority of the samples were heavily contaminated and can serve as source of infection to users, especially those with compromised immunity and children. This therefore calls for good manufacturing and packaging practices, use of treated water and other sterile raw materials, adequate environmental sanitation and personal hygiene, proper handling and storage which will reduce the bacterial loads to permissible limit and eradicate bacteria of public health importance. In other words auditing and quality control measures should be mandatory for all pharmaceutical companies and environment.

Effect of Bio-Additives and Kinetic Studies of Saccharomyces Cerevisiae on High Purity Alcohol Production Suitable for Medicinal Use

Alcohol is an indispensable ingredient in medicinal preparations like cough syrup, antiseptic, antidote, disinfectant, etc. In the present study, the alcohol production using Saccharomyces cerevisiae (yeast) and its growth kinetics were investigated in presence of the following bio-additives: Liquozyromol (plant extract), Avena sativa (oats), and Cicer arietinum (Bengal gram). The yeast’s specific growth rate and generation time for fermentation during alcohol production were determined to be 1.35 h-1 and 1.57 h-1 respectively. The Optimal concentration of Avena sativa (oats), Cicer arietinum (Bengal gram), and Liquozyromol for alcohol production were determined to be 8.6 g/l, 8.9 g/l, and 9.8 g/l respectively. Under the optimal conditions, the introduction of Cicer arietinum (Bengal gram) and Avena sativa (oats) had a minuscule impact on the alcohol quantity produced, while it increased considerably in presence of Liquozyromol. Also, the rate of fermentation decreased and volatile acidity was affected in presence of additives. Thus, the use of Liquozyromol as an additive greatly reduces the effect of secondary metabolites thereby increasing the quantity and the quantity of ethanol produced.

Bacterial contamination of retailed syrups traded in Wukari, North East, Nigeria

There is an increasing concern that syrups may contain pathogenic or non-pathogenic microbes that can pose as public health risk to patients. This research was to investigate the bacterial contamination of retailed syrups sold in Wukari. Eighteen (18) different brands of syrups were collected from different medicine stores in Wukari, North East Nigeria. These various brands of syrups were taken to the Microbiology Laboratory, Federal University Wukari for analysis using standard bacteriological techniques. The results show that syrups samples with contaminants included the M & B paracetamol, Emzor paracetamol, M & B flagyl (Loxagyl), Emzor Chloroquin, M & B Antimalarial preparation (Artelumex), Emzor cough syrup (Emzolyn), Emzor digestion syrup (Emtrisil), Jawa digestion syrup (Jawasil), Emzor multivitamin (Emvite), Tuyil pharmacy multivitamin (Vami-vite), Emzor blood tonic, and Jawa blood tonic while those that contained no contaminants included the Emzor flagyl(Emgyl), M & B chloroquin(Vinaquin), Emzor antimalarial preparation (Lokmal), Jawa cough syrup(D-Koff), Emzor vitamin c and Tuyil pharmacy vitamin C. The researched revealed that twelve (12) of the syrups were contaminated with bacteria isolates of Bacillus spp 9 (45%), Lactobacillus spp 5 (25%), Proteus spp 2 (10%), Staphylococcus aureus 2 (10%), Pseudomonas spp 1 (5%) and Klebsiella spp 1 (5%). The presence of the isolates could possibly be as a result of the production process and improper handling and protection of the containers containing the products. It is therefore recommended that monitoring agencies should ensure that these syrups do not present health hazards to the public during production and retail of products.

Coexistence of serotonin syndrome and neuroleptic malignant syndrome: does it exist?

We report a 21-year-old man with bipolar disorder who was on a stable dose of escitalopram and risperidone. Tramadol and cough syrup (dextromethorphan) were added for his recent attack of upper respiratory tract infection. However, he developed various neurological symptoms. Haloperidol and ondansetron were added after hospitalisation. However, his condition deteriorated. A diagnosis of serotonin syndrome (SS) was made, and cyproheptadine was started. Cyproheptadine provided relief in most of the symptoms within 48 hours except for the presence of fever and rigidity. The addition of bromocriptine provided a complete resolution of the symptoms. We considered the presence of both SS and neuroleptic malignant syndrome (NMS) in this case. There are four similar cases in the literature. We discussed a diagnostic and therapeutic approach for patients who are on both serotonergic agents and neuroleptics and develop SS-like or NMS-like clinical features.

Assessment of Microbial Qualities of Some Cough Syrups and Multivitamins Marketed in Pokhara, Nepal

Recently, the manufacturers of pharmaceuticals have improved the quality of non-sterile pharmaceuticals in such a way that such products contain only minimal bioburden. However, the production of sub-standard cough syrups and multivitamin syrups may cause non-therapeutic effect in patients, particularly in children. For this reason, this study was conducted to evaluate the microbiological quality of cough syrup and multivitamin syrups marketed in Pokhara, Nepal. Different brands of 15 cough syrups and 15 multivitamin syrups were collected from different vendors of Pokhara and the spread plate technique was performed to enumerate the microbial contaminant from the collected samples. Among 15 cough syrups, 12 samples were found to be contaminated with bacteria and nine samples were found to be contaminated with fungi. Similarly, among 15 multivitamin syrups, 10 were found to be contaminated with bacteria whereas 12 were found to be contaminated with fungi. Escherichia coli was not isolated in any samples. Overall, 14(93.33%) of cough syrup and 13(86.67%) of multivitamin syrups were found to be contaminated by either bacteria, fungi, or by both which exceeded the acceptance limit of International Pharmacopeia. The prevalence of these microorganisms in pharmaceutical products such as syrups samples may indicate the unhygienic condition, defect in production, poor adoption of Good Manufacturing Practice, ineffective preservatives and inadequate quality control. Though these products fall under non-sterile pharmaceutical products, so they need not require sterility but these drugs must conform to the microbiological purity criteria set in the appropriate pharmacopeial standard. These contaminated syrups explain the poor treatment and complicacy of the uncompromised people and the sick children.