Xanthinol (xanthinol nicotinate) is a xanthine derivative, peripheral vasodilator agent. It exerts it`s pharmacological action by acting as a vasodilator and improves blood flow to brain, arteries, and to the periphery. It increases brain glucose metabolism and thus improves brain ATP levels. It stimulates memory and concentration elevates brain energy levels. Indications for Xanthinol Nicotinate: 1. Peripheral vascular sclerosis 2. Cerebral circulatory disorders 3. Arteriosclerosis 4. Endarteritis obliterans 5. Short term memory disorders 6. Mental flagging 7. Anti ageing memory support 8. Diabetic angiopathy 9. Diabetic gangrene 10. Hyperlipidaemia 11. Intermittent claudication Side Effects of Xanthinol Nicotinate: 1. Flushing 2. Feeling of warmth 3. Nausea 4. Heart burn 5. Vomiting 6. Itching of skin For 30 years, Xanthinol nicotinate has been on the market for the treatment of impaired brain function, i.e., organic brain syndromes of various etiologies. Controlled double-blind phase-III clinical trials have shown that xantinol nicotinate is also an effective drug in the treatment of dementia. Xanthinol nicotinate is also helpful in the management of leg ulcers associated with haemoglobinopathies. Xanthinol was approved as a drug in 1998 in Canada and nowadays its status is cancelled post marketing. The positively charged xanthinol ion is thought to help the transportation of the nicotinic acid into the cell since the later cannot freely diffuse through the cell membrane. The mechanism of action is thought to be related to present influence in the cell metabolism through the nucleotides NAD and NADP. Also, the nicotinic acid is a coenzyme for a lot of proteins involved in tissue respiration (Embden-Meyerhof and citrate cycle). The effect of xanthinol nicotinate causes an increase in glucose metabolism and energy gain.

Cafedrine, also known as norephedrinoethyltheophylline, is a chemical linkage of norephedrine and theophylline and is a cardiac stimulant used to increase blood pressure in people with hypotension. There are few data available for cafedrine. Cafedrine has a half-life of 60 min following both oral and intravenous administration Cafedrine is metabolized to norephedrine and several minor metabolites, but nearly 90% of the administered norephedrine is excreted via the kidneys, mostly unchanged, within 24 h. The effects of cafedrine on cardiac output are believed to be mediated via β- adrenoceptors. Cafedrine has a positive inotropic effect in humans, and this can be abolished by administration of the non-selective β-adrenoceptor antagonist propranolol. A combination of cafedrine and theodrenaline called Akrinor® is used for the treatment of hypotension in adults that occurs during emergency situations, general anesthesia, and regional anesthesia, especially during cesarean sections. Cafedrine/theodrenaline may have advantages over other vasopressor drugs. For example, it can be administered via bolus while catecholamines normally need to be diluted and administered via syringe pumps. Bolus injection is faster, which may be beneficial in emergency situations, plus it is more cost efficient with respect to the disposables. Cafedrine/theodrenaline has been widely used in Germany since 1963

Etamiphylline is the respiratory stimulant. No information is available about pharmacodynamics of etamiphylline. No human pharmacokinetic data are available. Etamiphylline seems to be a rather weaker bronchodilator than theophylline when administered orally.

Reproterol is a short-acting β2 adrenoreceptor agonist used in the treatment of asthma. Reproterol increases the generation of cAMP in isolated peripheral blood monocytes in vitro more effectively than does orciprenaline. In the presence of the highly potent but nonselective ß-antagonist, propranolol, the cAMP-generating action of reproterol was inhibited only partially. Reproterol has gained wide use when it was licensed as a fixed combination therapy with cromoglycate. Until today, the bronchodilator effects of reproterol and the bronchoprotective and anti-inflammatory actions of cromoglycate combined in one inhaler remain the successful fixed combination of a disease-modifying and symptomatic drug for the treatment of asthma.

Bamifylline (or bamiphylline), a selective antagonist of the A1 adenosine receptor, was studied in the therapy of asthmatic syndromes.

Acefylline is a stimulant drug of the xanthine chemical class. It acts as an adenosine receptor antagonist. Acephylline piperazine is a theophylline derivative with a direct bronchodilator action. It has the advantages over theophylline in being far less toxic and producing minimal gastric irritation. It is indicated for the treatment of asthma, emphysema, acute and chronic bronchitis associated with bronchospasm.Acefylline relaxes smooth muscles, relieves bronchospasm & has a stimulant effect on respiration. It stimulates the myocardium & central nervous system, decreases peripheral resistance & venous pressure & causes diuresis. The mechanism of action is still not clear, inhibition of phosphodiesterase with a resulting increase in intracellular cyclic AMP does occur, but not apparently at concentrations normally used for clinical effect. Other proposed mechanisms of action include adenosine receptor antagonism, prostaglandin antagonism & effects on intracellular calcium. Sodium phenobarbital is a non-selective central nervous system depressant that is primarily used as sedative-hypnotic.