Terpin

Terpin
Clinical data
Other names	Dipenteneglycol, p-menthane-1,8-diol
ATC code	None;
Identifiers
	IUPAC name 4-(2-Hydroxypropan-2-yl)-1-methylcyclohexan-1-ol;
CAS Number	565-48-0 ;
PubChem CID	6651;
ChemSpider	6399;
UNII	MPF495B08R;
ChEMBL	ChEMBL1651998;
CompTox Dashboard (EPA)	DTXSID00947401 ;
ECHA InfoCard	100.123.310
Chemical and physical data
Formula	C10H20O2
Molar mass	172.268 g·mol−1
3D model (JSmol)	Interactive image;
	SMILES CC1(CCC(CC1)C(C)(C)O)O;
	InChI InChI=1S/C10H20O2/c1-9(2,11)8-4-6-10(3,12)7-5-8/h8,11-12H,4-7H2,1-3H3; Key:RBNWAMSGVWEHFP-UHFFFAOYSA-N;

Terpin, used as the hydrate (terpin·H₂O), is an expectorant, used to loosen mucus in patients with bronchitis and related conditions. It is derived from sources such as turpentine, oregano, thyme, and eucalyptus. 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 (FDA) found a lack of evidence of safety and effectiveness.^[1] Elixirs 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 and linalool by adding dilute acids (5% sulfuric acid) to them.^{[citation needed]}

Medical uses

Terpin hydrate is an expectorant, used in the treatment of acute and chronic bronchitis, pneumonia, bronchiectasis, chronic obstructive pulmonary disease, and infectious and inflammatory diseases of the upper respiratory tract. It is typically formulated with an antitussive (e.g., codeine) 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, codeine metabolism, as well as abuse potential.^{[citation needed]}

Mechanism 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.^[2]

History

Terpin hydrate was first physiologically investigated by Lépine 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.^[3]

The following preparations of terpin hydrate were available in the United States in 1907:^[3]

Elixir of terpin hydrate
Elixir of terpin hydrate with codeine
Elixir of terpin hydrate with heroin

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.^[1]

References

^ ^a ^b United States Food and Drug Administration: Code of Federal Regulations, Title 21, Volume 5, April 1, 2009
^ Codeine with Terpin hydrate Archived 2010-11-20 at the Wayback Machine
^ ^a ^b Drug Store Museum: Terpin Hydrate Archived 2011-01-14 at the Wayback Machine

[FDA-1] United States Food and Drug Administration: Code of Federal Regulations, Title 21, Volume 5, April 1, 2009

[2] Codeine with Terpin hydrate Archived 2010-11-20 at the Wayback Machine

[Museum-3] Drug Store Museum: Terpin Hydrate Archived 2011-01-14 at the Wayback Machine

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