Terpin is an expectorant, used to loosen

mucus Mucus (, ) is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both Serous fluid, serous and muc ...

in patients with

bronchitis Bronchitis is inflammation of the bronchi (large and medium-sized airways) in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. ...

and related conditions. It is used as the hydrate (terpin·H₂O). It is derived from sources such as

turpentine Turpentine (which is also called spirit of turpentine, oil of turpentine, terebenthine, terebenthene, terebinthine and, colloquially, turps) is a fluid obtainable by the distillation of resin harvested from living trees, mainly pines. Principall ...

oregano Oregano (, ; ''Origanum vulgare'') is a species of flowering plant in the mint family, Lamiaceae. It was native to the Mediterranean region, but widely naturalised elsewhere in the temperate climate, temperate Northern Hemisphere. Oregano is a ...

thyme Thyme () is a culinary herb consisting of the dried aerial parts of some members of the genus ''Thymus (plant), Thymus'' of flowering plants in the mint family Lamiaceae. Thymes are native to Eurasia and north Africa. Thymes have culinary, medici ...

, and

eucalyptus ''Eucalyptus'' () is a genus of more than 700 species of flowering plants in the family Myrtaceae. Most species of ''Eucalyptus'' are trees, often Mallee (habit), mallees, and a few are shrubs. Along with several other genera in the tribe Eucalyp ...

. It was used in the United States in the late nineteenth century, but was removed from marketed medications in the 1990s after the

Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a List of United States federal agencies, federal agency of the United States Department of Health and Human Services, Department of Health and Human Services. The FDA is respo ...

(FDA) found a lack of evidence of safety and effectiveness.United States Food and Drug Administration
Code of Federal Regulations, Title 21, Volume 5, April 1, 2009
/ref>

Elixir An elixir is a sweet liquid used for medical purposes, to be taken orally and intended to cure one's illness. When used as a dosage form, pharmaceutical preparation, an elixir contains at least one active ingredient designed to be taken orall ...

s of terpin hydrate are still available with a prescription, but must be prepared by a compounding pharmacy. It can be prepared from other volatile oils like

geraniol Geraniol is a monoterpenoid and an alcohol. It is the primary component of citronella oil and is a primary component of rose oil and palmarosa oil. It is a colorless oil, although commercial samples can appear yellow. It has low solubility i ...

and

linalool Linalool () refers to two enantiomers of a naturally occurring terpene alcohol found in many flowers and spice plants. Together with geraniol, nerol, and citronellol, linalool is one of the rose alcohols. Linalool has multiple commercial app ...

by adding dilute acids (5%

sulfuric acid Sulfuric acid (American spelling and the preferred IUPAC name) or sulphuric acid (English in the Commonwealth of Nations, Commonwealth spelling), known in antiquity as oil of vitriol, is a mineral acid composed of the elements sulfur, oxygen, ...

) to them.

Medical uses

Terpin hydrate is an expectorant, used in the treatment of acute and chronic

pneumonia Pneumonia is an Inflammation, inflammatory condition of the lung primarily affecting the small air sacs known as Pulmonary alveolus, alveoli. Symptoms typically include some combination of Cough#Classification, productive or dry cough, ches ...

bronchiectasis Bronchiectasis is a disease in which there is permanent enlargement of parts of the bronchi, airways of the lung. Symptoms typically include a chronic cough with sputum, mucus production. Other symptoms include shortness of breath, hemoptysis, co ...

chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is a type of progressive lung disease characterized by chronic respiratory symptoms and airflow limitation. GOLD defines COPD as a heterogeneous lung condition characterized by chronic respiratory s ...

, and infectious and inflammatory diseases of the upper respiratory tract. It is typically formulated with an

antitussive Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including ana ...

, such as

codeine Codeine is an opiate and prodrug of morphine mainly used to treat pain, coughing, and diarrhea. It is also commonly used as a recreational drug. It is found naturally in the sap of the opium poppy, ''Papaver somniferum''. It is typically use ...

, as a combined preparation.

Adverse effects

Adverse reactions include depression of the respiration, sedation, coordination disorders, constipation, and urinary retention. Long-term administration of the 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 depression of the

central nervous system The central nervous system (CNS) is the part of the nervous system consisting primarily of the brain, spinal cord and retina. The CNS is so named because the brain integrates the received information and coordinates and influences the activity o ...

, codeine metabolism, as well as abuse potential.

Mechanism of action

humectant A humectant is a hygroscopic (water-absorbing) substance used to keep things moist. They are used in many products, including food, cosmetics, medicines and pesticides. When used as a food additive, a humectant has the effect of keeping moistu ...

and expectorant, terpin hydrate works directly on the

bronchial A bronchus ( ; : bronchi, ) is a passage or airway in the lower respiratory tract that conducts Atmosphere of Earth, air into the lungs. The first or primary bronchi to branch from the trachea at the Carina of trachea, carina are the right main b ...

secretory Secretion is the movement of material from one point to another, such as a secreted chemical substance from a cell or gland. In contrast, excretion is the removal of certain substances or waste products from a cell or organism. The classical mec ...

cells in the

lower respiratory tract The respiratory tract is the subdivision of the respiratory system involved with the process of conducting air to the alveoli for the purposes of gas exchange in mammals. The respiratory tract is lined with respiratory epithelium as respirator ...

to liquify and facilitate the elimination of bronchial secretions. It also exerts a weak antiseptic effect on the pulmonary parenchyma.Codeine with Terpin hydrate

History

Terpin hydrate was first

physiologic Physiology (; ) is the scientific study of functions and mechanisms in a living system. As a subdiscipline of biology, physiology focuses on how organisms, organ systems, individual organs, cells, and biomolecules carry out chemical and ...

ally investigated by Lépine in 1855. He reported that it acted upon the

mucous membrane A mucous membrane or mucosa is a membrane that lines various cavities in the body of an organism and covers the surface of internal organs. It consists of one or more layers of epithelial cells overlying a layer of loose connective tissue. It ...

s and also the

nervous system In biology, the nervous system is the complex system, highly complex part of an animal that coordinates its behavior, actions and sense, sensory information by transmitting action potential, signals to and from different parts of its body. Th ...

in a manner similar to the oil of turpentine. The following preparations of terpin hydrate were available in the United States in 1907: * Elixir of terpin hydrate * Elixir of terpin hydrate with

* Elixir of terpin hydrate with

heroin Heroin, also known as diacetylmorphine and diamorphine among other names, is a morphinan opioid substance synthesized from the Opium, dried latex of the Papaver somniferum, opium poppy; it is mainly used as a recreational drug for its eupho ...

Currently available expectorants in the United States

Currently,

guaifenesin Guaifenesin, also known as glyceryl guaiacolate, sold under the brand name Mucinex, among others, is an expectorant medication taken by mouth and marketed as an aid to eliminate sputum from the respiratory tract. Chemically, it is an ether of ...

(glyceryl guaiacolate) is the only FDA approved expectorant in the United States. Besides terpin hydrate, other expectorants lacking evidence of efficacy include

ammonium chloride Ammonium chloride is an inorganic chemical compound with the chemical formula , also written as . It is an ammonium salt of hydrogen chloride. It consists of ammonium cations and chloride anions . It is a white crystalline salt (chemistry), sal ...

, beechwood

creosote Creosote is a category of carbonaceous chemicals formed by the distillation of various tars and pyrolysis of plant-derived material, such as wood, or fossil fuel. They are typically used as preservatives or antiseptics. Some creosote types w ...

, benzoin preparations,

camphor Camphor () is a waxy, colorless solid with a strong aroma. It is classified as a terpenoid and a cyclic ketone. It is found in the wood of the camphor laurel (''Cinnamomum camphora''), a large evergreen tree found in East Asia; and in the kapu ...

, eucalyptol/

eucalyptus oil Eucalyptus oil is the generic name for distilled oil from the leaves of ''Eucalyptus'', a genus of the plant family Myrtaceae, mostly native to Australia but cultivated worldwide. Eucalyptus oil has a history of wide application, as a pharmace ...

iodine Iodine is a chemical element; it has symbol I and atomic number 53. The heaviest of the stable halogens, it exists at standard conditions as a semi-lustrous, non-metallic solid that melts to form a deep violet liquid at , and boils to a vi ...

ipecac Syrup of ipecac (), or simply ipecac, is a drug that was once widely used as an expectorant (in low doses) and a rapid-acting emetic (in higher doses). It is obtained from the dried rhizome and roots of the ipecacuanha plant ('' Carapichea ipe ...

syrup,

menthol Menthol is an organic compound, specifically a Monoterpene, monoterpenoid, that occurs naturally in the oils of several plants in the Mentha, mint family, such as Mentha arvensis, corn mint and peppermint. It is a white or clear waxy crystallin ...

peppermint oil Peppermint extract is an extract of peppermint (''Mentha × piperita'') made from the essential oil of peppermint leaves. Peppermint is a hybrid of water mint and spearmint. The oil has been used for various purposes over centuries. Peppermint ...

pine tar Pine tar is a form of wood tar produced by the high temperature carbonization of pine wood in anoxic conditions (dry distillation or destructive distillation). The wood is rapidly decomposed by applying heat and pressure in a closed container; t ...

preparations, potassium guaiacolsulfonate,

sodium citrate Sodium citrate may refer to any of the sodium salts of citric acid (though most commonly the third): * Monosodium citrate * Disodium citrate * Trisodium citrate The three forms of salt are collectively known by the E number E331. Applications ...

, squill preparations, tolu and turpentine oil.

References

{{Cough and cold preparations Expectorants