Terpin hydrate

Terpin hydrate

Identifiers
ChEMBL	ChEMBL1651998
Jmol interactive 3D	Image
SMILES CC(C)(O)C1CCC(C)(O)CC1
Except where otherwise noted, data are given for materials in their standard state (at 25 °C [77 °F], 100 kPa).
Infobox references

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. Though it was quite popular in the USA since the late nineteenth century, it was banned by the U.S. Food and Drug Administration (FDA) in the 1990s due to lack of proof of efficacy.^[1]

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.^[2]

The following preparations of Terpin hydrate were available in the USA in 1907 (Taken from The Dispensatory Of The United States Of America. Nineteenth Edition. By Dr. Geo. B.Wood And Dr. Franklin Bache. Based Upon The Eighth Decennial Revision Of The United States Pharmacopoeia Issued June 1, 1907):^[2]

• Elixir of Terpin Hydrate
• Elixir of Terpin Hydrate with Codeine
• Elixir of Terpin Hydrate with Heroin

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 liquefy and facilitate the elimination of bronchial secretions. It also exerts a weak antiseptic effect on the pulmonary parenchyma.^[3]

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 reactions

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 this combination is not as readily as soluble in water. This combination can also cause complications and problems of cross dependence with alcohol and codeine as well as increase codeine metabolism and side-effects.

The side effects of this combination product are related to its high alcohol content (42 percent). If enough ethanol is consumed it will produce significant CNS depression.

Perfidia, a novel by James Ellroy, talks at length about Terpin hydrate abuse, mostly by Japanese immigrants in the USA in the first half of the 20th century.

Currently available expectorants in the USA

Currently, guaifenesin (Glyceryl Guaiacolate) is the only agent approved by the FDA for use as an expectorant in the USA. Formerly used expectorants like 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, terpin hydrate, tolu and turpentine oil, must be reformulated.^[1]

References