Description: Terbutaline is a selective β-2-adrenoceptor agonist. At therapeutic doses it acts on the β- 2-adrenoreceptors of bronchial muscle with little or no action on the α1-adrenoreceptors of cardiac muscle. Terbutaline stimulates the production of intracellular cyclic-AMP, enhancing the binding of intracellular calcium to the cell membrane and endoplasmic reticulum, resulting in bronchodilation. It also enhances mucociliary clearance. Activation of the β-2-adrenoreceptors opens ATPase channels and drives potassium from the extracellular to the intracellular space. This both decreases extracellular hyperkalemia and increases intracellular potassium, so decreasing the chance of arrhythmia. Ambroxol hydrochloride is a mucolytic agent, which liquefies thick, tenacious sputum. Ambroxol dissolves mucopolysaccharide fibres and reduces viscosity of sputum. It also improves mucociliary clearance of secretions. Guaiphenesin is an expectorant. It increases the output of sputum and bronchial secretions by reducing adhesiveness and surface tension. By increasing the volume of bronchial secretions, it reduces the viscosity of tenacious sputum. The increased flow of less viscid secretions also promotes ciliary action. Menthol has a cooling effect on the throat. It has been suggested that the benefits of menthol may be due to an effect on calcium channels of sensory nerves.

Composition: Each 5ml contains: Terbutaline sulphate 1.2mg, Ambroxol Hcl 15mg, Guaiphenesin 10mg, menthol 1mg.

Indications: Mucokine Exp indicated for the treatment of productive cough when associated with bronchospasm in conditions such as bronchitis, bronchial asthma, chronic obstructive pulmonary disease (COPD), bronchiectasis and emphysema.

Dosage and administration: The usual recommended dose of Muckoine exp in children is as under: • 6-12 years age: 1-2 tsp bid or t.i.d. • 4-6 years age: 1 tsp bid or t.i.d. • 2-4 years age: ½ tsp bid or t.i.d. or as directed by physician.

Note: Terbutaline dose: 0.075 mg/kg body wt. t.i.d.