What are mucolytics

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Mucolytic agents

What does mucolytic mean?

Almost every one of us has had a cold, bronchitis or respiratory infections that were accompanied by coughing and sputum production. Mucolytic drugs have a secretolytic effect and help thin mucus, speed up its release and facilitate breathing.

Table of contents:

They are prescribed when thick mucus forms in diseases. These diseases include: pneumonia, bronchitis, rhinitis, sinusitis, sinusitis, laryngitis, ear inflammation. A feature of mucolytic agents is the improvement of the process of sputum discharge without increasing its volume.

Classification of mucolytic agents

Mucolytic drugs are divided into three main groups:

  • affecting the viscosity of mucus;
  • activating the release of sputum;
  • reducing the amount of mucus.
Medicines that affect bronchial secretion can be of direct or indirect action. Drugs that destroy polymer mucous bonds act directly.

Indirect acting drugs include:

  • changing the biochemical composition of mucus;
  • changing the adhesion of the gel layer;
  • affecting hydration;
  • balms and volatile substances;
  • drugs that stimulate the gag reflex;
  • changing activity in the bronchial glands.

Mechanism of action of mucolytic agents

The effects of mucolytic drugs are aimed at facilitating the removal of mucus from the respiratory tract. In the process, the serous mucosal cells on the lining of the bronchi are stimulated, during which the disturbed ratio of the mucous and serous components is restored and hydrolase is activated. The action of the drugs is also aimed at breaking the disulfide bonds of sputum and inhibiting the formation of mucus.

Mucolytic drugs

Mucolytic drugs are used to treat a dry cough to turn it into a wet one. They are also used to treat nasal inflammation. For sinusitis, Fludex, Fluimucil and Mucodin are mainly used. They contain carbocysteine, which helps remove mucus and restore breathing. At the same time, it helps fight sinusitis and rhinitis.

Mucolytic agents of plant origin

The use of plants as medicine comes to us from ancient times. This is due to the fact that they have noticeable advantages over synthetic drugs. First of all, these are minimal side effects. Traditionally, plant extracts, dry mixtures, oils, and herbal mixtures are used. They have anti-inflammatory properties, reduce swelling of the mucous membrane and significantly facilitate the discharge of sputum. Phytoncytes, found in many herbs, help fight bacteria and viruses. They have a pleasant taste that children and adults enjoy. In some cases, allergic reactions may occur. It is important to closely monitor the body's reaction.

Preparations based on thyme, in addition to their main effect, reduce soreness and hoarseness. Such a drug is Bronchicum. It is sold in the form of syrup, lozenges and elixir.

The content of ivy leaf extract in the preparations has an expectorant effect and reduces spasms in the bronchi. Sage has bactericidal properties and treats not only coughs, but also pharyngitis and laryngitis. Marshmallow root thins mucus and creates conditions for its easy removal. Medicines based on a combination of thyme and plantain extracts are used to treat tracheitis and bronchitis, when it is difficult to cough. Such medicines include Mukaltin and Linkas, which also contain violet and hyssop.

Expectorants and mucolytics

Expectorants have reflex and resorptive action. The former contain saponin and alkaloids (infusions of thermopsis, marshmallow and istod). When taken, they irritate the stomach receptors, and this leads to stimulation of the vagus nerve in the brain. Further, the secretion of mucus in the bronchi increases and the bronchial muscles contract. Resorptive drugs (eucalyptus oil, thyme, anise fruits) are absorbed into the gastrointestinal tract, released in the form of mucus and dilute sputum. Preparations containing iodine help break down sputum proteins. The mucolytic effect causes the sputum to become viscous and drain well. At the same time, the secretory function of the bronchial glands is normalized. The effect occurs within thirty minutes and lasts up to ten hours.

List of mucolytics

Mucolytics have several dosage forms and provide different modes of delivery. This can be oral, endobronchial or inhalation. This allows the use of mucolytic agents as a means of complex therapy in the treatment of acute and chronic stages of respiratory disease. This is also indicated for the treatment of ENT organs with the release of purulent secretion. These drugs are suitable even for treating infants.

Mucolytic agents for children

Preparations based on marshmallow are used to treat diseases in children. They are used for pneumonia, obstructive bronchitis, and pulmonary enphysema. Such medicines include: Mukaltin, Alteika syrup, marshmallow roots in the form of herbs.

Thermopsis preparations have a pronounced expectorant property. They reduce the viscosity of sputum and stimulate the secretory function of the bronchi. These include: Codelac Broncho, Codelac Broncho with thyme, Stoptussin phyto syrup, Coldrex broncho, Bronchicum, Pertussin.

Breast mixtures No. 1, 2, 3, 4 are also used in treatment, which include oregano, coltsfoot, sage, almost pine anise, licorice, wild rosemary.

Mucolytic cough suppressants

Acetylcysteine ​​is one of the most active drugs. The medicine has antitoxic and antioxidant properties and has a thinning effect on sputum. Analogs of the drug are Airbron, Mucomist, Fluimucil, ACC, Mukobene, Inspiron. The drugs are produced in the form of a solution for inhalation, as well as in ampoules.

In addition to its mucolytic effect, carbocisteine ​​also restores the activity of secretory cells. Analogues are Mukodin, Fluvik, Drill, Bronkatar. These syrup forms can be used by patients with diabetes. Also available in capsule form.

Bromhexine has an expectorant effect and is used for acute bronchitis. Its analogues are Bisolvon, Mukovin, Fulpen, Brodisol, Bromobenzonium. Tablets, syrups, oral solutions, elixirs, and also as inhalations are used in treatment.

Ambroxol affects the synthesis of bronchial secretions. It is used for acute chronic diseases.

Phlegamine is a combination medicine that contains mint and eucalyptus oil, menthol and bromhexine. It is used to thin and expectorate mucus.

Gelomirtol Forte or Myrtol standardized is used to eliminate the viscosity of sputum and make it easier to pass. It helps with chronic bronchitis and inflammation of the sinuses. The drug is available in the form of capsules of different dosages.

Mesna, Mucolen, Mistabron or Mycoflud resemble Acetylcysteine ​​in their action. These medications are used to treat chronic bronchitis in the form of inhalations and injections.

Source: http://kashelb.com/lekarstva-ot-kashlya/362-mukoliticheskie-sredstva

Mucolytic agents

Medicines classified as mucolytic have secretolytic properties, helping to liquefy mucus, speed up its elimination and facilitate breathing. Mucolytic agents are prescribed for diseases accompanied by the formation of thick mucus (bronchitis, pneumonia, tracheitis) and for ENT diseases (sinusitis, sinusitis, rhinitis).

Mucolytic action - what is it?

The peculiarity of such funds is to improve the discharge of sputum without increasing its volume. These drugs are divided into three groups based on their principle of action:

  • affecting the viscosity of mucus;
  • activating the removal of sputum;
  • reducing mucus formation.

Mucolytic agents for dry cough

An important stage in the treatment of cough is its transition from dry to wet. This is achieved by taking mucolytics, which make sputum less viscous and thin it. Let us briefly describe the most effective medications.

Available in the form of tablets and granules for dissolution in water, as well as in the form of a solution for injection. Its high effectiveness is explained by its triple effect: antitoxic, mucolytic and antioxidant. The drug helps remove phlegm and reduces inflammation. The action of the medicine is based on the property of depolyzing mucoproteins, reducing viscosity and pus.

Its properties are similar to Bromhexine, however, it has a more pronounced expectorant effect. The drug activates the formation of pulmonary surfactant and stimulates expectoration.

This remedy should also be classified as a mucolytic cough medicine, which not only promotes the removal of mucus, but also restores the functioning of secretory cells. The medicine is available in the form of syrup and capsules.

Mucolytic drugs for the nose

Mucolytics are also prescribed to prevent the accumulation of mucus in nasal diseases. They are prescribed in combination with antimicrobial agents and home treatments.

The following mucolytic drugs for sinusitis are distinguished:

The carbocysteine ​​content in them helps to remove viscous secretions, restore the mucous membrane, and facilitate breathing. Experts recommend using them to combat rhinitis and sinusitis. The effectiveness is due to the effect on several mucous membranes of the body at once, which helps to more productively eliminate phlegm.

Mucolytic herbal medicines

Many people prefer to limit their intake of medications produced without the use of natural ingredients. However, we must remember that herbal preparations, like chemical ones, have their contraindications and side effects.

The main product is polysaccharide components, which are extracted from the marshmallow plant. The root of the plant contains aspargine, betaine, starch, and mucus, which relieves inflammation.

It is another mucolytic herbal remedy. It is sold in the form of a syrup, which contains hyssop, marshmallow, licorice root, violet, etc.

Sold in the form of an elixir, syrup and lozenges. The drug has a combined effect on the body, providing anti-inflammatory, bronchodilator and expectorant effects. The main elements of the product are primrose root and thyme herb. The medicine improves the condition of dry and wet cough, helps make it productive, facilitating the removal of mucus from the lungs.

Helps cope with both the first signs of a cold and the progressive disease. The drug activates self-cleaning mechanisms, getting rid of germs and thinning mucus.

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Source: http://womanadvice.ru/mukoliticheskie-sredstva

Mucolytics and expectorants: what is the difference, popular drugs

Almost all colds, inflammatory diseases of a bacterial or viral nature, are accompanied by a cough. Depending on the nature of the pathology and the physiological state of the lungs and bronchi, the cough may be accompanied by sputum (wet) or not accompanied by secretions (dry).

Modern pharmaceutical companies offer many products to help cope with coughs of various etiologies and prevent its unpleasant consequences.

What are expectorants and mucolytics used for?

Dry cough is considered the most dangerous for the body. A sharp contraction of the bronchi without secretion of the product leads to various pathological conditions. In the absence of sputum production, the cough reflex causes a lot of suffering. Moisturizing the respiratory mucosa is vital for the body, since this secretion helps the internal organs protect themselves from the negative effects of pathogenic microorganisms and dangerous factors of the external and internal environment.

A cough with a large amount of mucus discharge can also be life-threatening, since the production of mucus by the bronchi more than is physiologically necessary leads to blockage of the airways and serious difficulty breathing in the future. Accumulating in the bronchi, sputum can gradually thicken and harden, accumulating harmful substances and provoking the risk of developing a more serious condition for the patient.

It is in the mechanism of action on the lungs and bronchi that the main difference between expectorants and mucolytic drugs lies.

Expectorants promote active mucus production. They act on the cough center of the brain and help the bronchi contract more intensely, removing phlegm out.

Mucolytic agents are used in cases where, during the course of the disease, too much sputum is produced and at the same time it has an extremely dangerous, viscous and thick consistency. Mucolytics are needed to break down the molecular bonds inside the sputum, making it more liquid and accessible to natural elimination from the body.

After the mucus becomes easily separated and its passage through the respiratory tract does not cause difficulties, doctors recommend either switching from mucolytics to expectorants, or immediately prescribing a combination drug that can have several therapeutic effects on the human respiratory system.

Types of expectorants

Expectorants are also called “secretomotor”, since they are the ones that can start the process of mucus secretion and ease the internal condition of the human respiratory organs.

Depending on the mechanism of action of expectorant drugs, experts divide such drugs into two groups:

  1. reflex drugs;
  2. direct acting drugs.

Reflex-action drugs actively affect the receptors responsible for the secretion of secreted sputum. This occurs due to preliminary irritation of the stomach receptors and an active effect on the cough center of the medulla oblongata. This mechanism of action helps to enhance the severity of the cough reflex and accelerate the synthesis of liquid bronchial secretions.

as reflexive drugs :

  • Liquorice root . It is used both in the form of a decoction and in the form of a syrup prepared with the addition of sugar and ethyl alcohol. Additionally, pediatricians recommend giving children licorice-based lollipops as maintenance therapy. The root of this medicinal plant contains a powerful saponin component - glycyrrhizin. This active substance stimulates the activity of the glandular epithelium, helping the bronchi secrete a sufficient amount of mucus. In addition, the steroid compounds contained in licorice root help to provide an additional calming, wound-healing and anti-inflammatory effect on the tissues of the respiratory system, which greatly facilitates the course of the disease.
  • Preparations based on thermopsis extract . The effect of these drugs is similar to that of drugs made from licorice root due to a similar mechanism of action. Thermopsis root is included in a large number of medicines, such as tablets with dry extract, brewing powder, Cough tablets, Thermopsol. Thermopsis extract can also be found in combined medicinal tablets and syrups: Amtersol, Codelac, Codelac Broncho, Codelac Neo, Dry Cough Medicine. The dosage form of the drug and the method of administration are chosen based not only on the age and clinical condition of the patient, but also based on his preferences for taking pharmacological agents.
  • Preparations containing sodium benzoate . This active substance is never used in multicomponent form, only as part of combined pharmacological agents. The most popular of them are Dry Cough Mixture and Amtersol. Sodium benzoate inhibits the activity of dangerous enzymes and can have an active effect on the processes of mucus separation and sputum removal from the body.

It can provoke a large number of side effects and allergic reactions, so pharmaceuticals containing sodium benzoate are used with caution, under the supervision of a doctor.

  • Essential oils : terpene and eucalyptus. The most well-known preparations containing a large number of such oils are Eucabal, Doctor Mom, as well as herbal cough medicines with a high percentage of essential oil raw materials. These active substances have an expectorant and anti-inflammatory effect, acting both on the receptors responsible for the production of mucus and directly on the epithelium lining the surface of the respiratory organs.

Direct-acting expectorants help to strengthen the liquid component of sputum, significantly facilitating its separation. The main side effect of these active substances is increased snot secretion and lacrimation, since the drug can affect the viscosity of any physiological fluids of the body. Such drugs are considered classic or even outdated, and therefore are used quite rarely: sodium and potassium iodides, ammonia, anise essential oil.

The exceptions are oregano and wild rosemary, which are part of popular antitussive preparations, and are also contained in combined cough medicines: Doctor Mom, Bronchofit, etc.

Types of mucolytic agents

Mucolytic agents are classified mainly by their composition, since their mechanism of action is very similar: diluting the composition of sputum, changing its composition to something more easily separated from the surface of the bronchi and lungs, and gradually removing excess secretions from the body.

Among mucolytics, experts especially highlight the following drugs:

  • Guaifenesin preparations . This active substance can significantly reduce the degree of surface tension of pulmonary secretion and its density. Guaifenesin helps with moderate wet cough and mild bronchitis. Among the medicines containing this mucolytic component, the following are quite popular: Ascoril, Vicks Active Symptomax, Joset, Cashnol, Codelac Broncho, Tussin Plus.
  • Mucoregulator drugs : drugs with a high content of acetylcysteine ​​and carbocysteine. These drugs, in addition to being mucolytic, can stimulate the motor activity of epithelial cilia and provoke accelerated removal of sputum from the body. Thanks to the combination of motor and anti-inflammatory effects, taking medications containing acetylcysteine ​​and carbocysteine ​​will help cure not only cough, but also significantly reduce nasal congestion. Popular mucoregulators: ACC, Libexin, Acestin, Vicks Active Expectomed, Fluimucil, Fluditec.
  • Mucokinetics. This is an extensive list of drugs, the main effect of which is on the glandular cells in the tissues of the lungs and bronchi. They help produce the liquid component of sputum, as well as the production of surfactant - a substance that promotes the opening of the alveoli, freeing breathing and easier removal of excess secretions from the lungs. Mucokinetics can be used either as a monocomponent or as part of medications containing many active substances for a complex effect on the bronchi. These medications are considered the most popular and are actively prescribed by medical specialists for patients of all ages: Bromhexine, Ambrobene, Lazolvan, Flavamed, Bronchoxol.

To achieve the fastest effect, medical specialists recommend using mucolytic agents as inhalations, in special dosage forms for direct inhalation. This will significantly facilitate absorption processes and will not waste unnecessary time on the release of active metabolites directly in the body.

Despite the fact that almost all cough medications are available without a doctor’s prescription, before use it is advisable to consult with a specialist to select the most effective pharmacological agent in each specific clinical case.

If desired, the use of chemical medications can be combined with popular folk remedies and herbal antitussives. However, you need to remember that herbs may also be incompatible with the active pharmacological components of the medication you are taking. Before use, you should carefully read the instructions not only to become familiar with the mechanism of action and side effects, but also to find out exactly how to take this medicine and what additional therapeutic measures it combines well with.

Kuznetsova Irina, medical observer

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Mucolytic agents. Expectorants and sputum thinners

As a rule, illness strikes when a person is absolutely not ready to face it. The most common in modern society are viral infections, as well as diseases associated with damage to the respiratory system. The cough that accompanies such diseases can be dry or wet, but in any case it is necessary to help the body by removing mucus from the bronchi. Doctors, as part of complex therapy for respiratory diseases, prescribe mucolytics that help thin mucus, or expectorants that help eliminate it.

Mucus thinners

In case of illness accompanied by a dry, debilitating cough, it is important to clear the bronchi of accumulated mucus. The body tries to do this by coughing, however, if the phlegm is too thick, then it is not so easy to remove it. Doctors, after listening to the patient’s complaints about a dry, “barking” cough, as a rule, prescribe mucolytic drugs that help thin the sputum. Experts divide mucolytics into two groups: direct and indirect action. Both stimulate the functioning of the bronchial glands due to reflex irritation of the mucous membrane and, ultimately, contribute to the dilution of sputum. The question of what remedy to prescribe to the patient is decided by the doctor, having studied the nature of the disease and the picture of the course of the pathological process. That is why self-medication is not recommended, since the cough medicine that will help one person may be absolutely useless for another. Direct-acting mucolytic drugs include cysteine, acetylcysteine, and trypsin. Bromhexine and ambroxol have an indirect effect.

Main groups of mucolytics

Experts traditionally divide mucolytic agents into three types:

- helping to reduce the thickness of mucus

- promoting the removal of sputum

- helping to reduce the amount of mucus.

Medicines of the first group are prescribed to those patients whose cough is too dry, not accompanied by sputum production. They enhance the secretory function of the bronchi, thin the mucus, thereby facilitating its removal. In the event that sputum is excreted, but its amount is insignificant, and the secreted mucus is too thick and viscous, a mucolytic cough remedy of the second type is prescribed. Medicines belonging to the third type of mucolytics are used by doctors to treat coughs accompanied by significant secretion of thick mucus.

Mucolytics of plant origin

The use of plants for medicinal purposes came to us from our Slavic ancestors. Many herbs and flowers are known as excellent and effective remedies for coughs and colds, while causing virtually no unwanted effects. As a rule, herbal preparations, extracts, and dry mixtures that have an anti-inflammatory effect and help reduce swelling of the mucous membrane are used in pharmacology. Medicines based on thyme affect the upper respiratory tract, reducing inflammation in the throat. Such drugs include “Bronchicum”. A cough medicine containing ivy leaf extract and marshmallow root has a pronounced mucolytic effect and creates conditions for easy removal of phlegm. Remedies that combine thyme extract and plantain effectively cure tracheitis and bronchitis, accompanied by difficult sputum discharge. Such medications include cough tablets "Mukaltin" and syrup "Linkas".

Products for children

To treat cough in children, herbal preparations are usually used. They are prescribed for diseases of the upper and lower respiratory tract in children, and more protracted diseases of the lungs and bronchi. One of these medicines is Mukaltin. Tablets, the instructions for use of which allow their use in pediatrics, are actively prescribed as a medicine for the treatment of severe cough in young patients. An equally popular remedy for children is Alteyka syrup, as well as Pertussin, Stoptussin, Bronchicum. All these drugs are safe to use due to their plant origin. They reduce the density of sputum and improve the excretory function of the bronchi. Mucolytic drugs for children, as a rule, do not pose any harm to the baby, but before use you should definitely consult with your pediatrician, and treatment should be carried out under the supervision of doctors.

Medicines for adults

The modern pharmacy chain offers a fairly wide range of mucolytic drugs. Some are intended to treat only adult patients; the main contraindication to the use of such drugs is children under 12 years of age. The most common mucolytics for adults are:

— “Lazolvan” in syrup.

- Licorice root syrup.

— “Ambroxol” in tablet form;

— “Bromhexine” (tablets and mixture).

These drugs are the most common antitussives. Some of them are plant-based, others, in turn, are synthetic. But both are equally effective for diseases of the upper and lower respiratory tract.

Children's drugs

Pharmacies also have a fairly wide range of drugs for treating children's cough. For the most part, these are also mucolytic agents. The list of the most common children's cough medications is as follows:

— “Gedelix” in drops.

— “Doctor MOM” in syrup.

- Licorice root syrup.

— Dry children's cough medicine.

Considering that these drugs contain herbal components, the absence or presence of an allergic reaction to the components of the drugs should be taken into account.

Action of expectorants

Expectorants are designed to remove mucus from the bronchi, while effectively clearing the airways. As a rule, sputum production gradually decreases significantly, and the cough gradually goes away. The first group of expectorants has a pronounced irritant effect on the gastrointestinal tract, stimulating the gag reflex. But it doesn’t come to the point of vomiting, the production of mucus in the respiratory tract simply increases, thus the bronchi are cleansed and gradually healed. The second group of expectorant drugs acts directly on the bronchial mucosa, thereby stimulating their secretion. The effect of such expectorants is to some extent similar to that produced by mucolytic drugs.

Cough expectorants

Expectorants in the modern pharmacy assortment are presented in the form of herbal preparations and synthetic drugs. The decision to prescribe a particular drug is made by the doctor, taking into account the presence or absence of a cough, accompanied by the release of viscous and difficult to remove sputum. The most popular among patients are Lazolvan, Prospan, ACC 200, ACC Long, Sinekod, Bronchostop, Amrobene and other drugs.

Use of expectorants in children

Treatment of cough in children using expectorants is quite common. Despite the availability of a group of these drugs in the pharmacy chain and their free over-the-counter sales, doctors warn parents that self-medication with such drugs is dangerous for children. When looking for what can be defined as a good expectorant, parents should contact their pediatrician. The doctor will be able to correctly determine the nature of the pathological process in the child and select the optimal treatment. Some expectorants for children can have a dual effect: mucolytic and expectorant (for example, Mucaltin). Tablets, the instructions for use of which specify its sputum-thinning properties, also help remove it from the bronchi. If the baby has a wet cough, liquid sputum under the influence of mucaltin will liquefy even more and intensively accumulate, closing the lumen of the bronchi from the inside. This threatens the child with bronchial obstruction, and this will be caused by incorrectly selected treatment.

Expectorants for children

Many expectorants contain thermopsis herb. These are medications such as “Thermopsol” in tablet form, “Cough tablets”, “Codelac Broncho” in tablet form and in syrup. The use of these drugs for the complex treatment of diseases in children should be approached with caution, since even with a slight overdose the baby may vomit. Moreover, the components of these drugs stimulate respiratory function, which is replaced by depression. Therefore, parents should use such expectorants strictly as prescribed by the doctor, and follow the dosage prescribed by the doctor. You should know that the drug “Codelac” belongs to the group “Expectorants and mucolytics”, therefore the issue of using this drug for the treatment of children must be decided by a specialist.

Herbal remedies for babies

Marshmallow-based products are also effective medications for the treatment of cough in children. Most parents speak positively about treating coughs in their children with expectorants such as Mukaltin and Alteyka syrup. These drugs belong to the herbal group, and therefore are considered to be somewhat safe. However, you should know that side effects when using these medications also occur, and there are contraindications that should be taken into account. First of all, these are allergic reactions to the components of the drug, the baby’s history of other somatic disorders, for example, the gastrointestinal tract. The question of the advisability of using herbal preparations to treat children is also decided by a certified physician.

Treatment of cough in adult patients

Most people think that a good cough expectorant is an expensive and overhyped medicine. Often this opinion turns out to be erroneous, since the drug that helps eliminate a specific pathological condition will be effective. The cost of a drug does not depend on its effectiveness and efficiency, but is determined by the policies of the pharmaceutical company and the manufacturer. A cough in which there is no sputum is considered dry. Most often, doctors recommend cough suppressants: Sinekod, Codeine, Cofex. If sputum discharge is poor, completely different drugs will be effective - not those that suppress the cough, but those that help thin the sputum. The most popular are “Gedelix”, “Lazolvan”, “Prospan”. A wet cough, as a rule, is accompanied by a copious accumulation of mucus in the respiratory tract, which is why doctors recommend expectorants that do not have a pronounced mucolytic property: Ambroxol, Bromhexine, Erespal. A properly selected medication is the key to a quick and complete recovery, which is why doctors do not recommend self-medication for either children or adults.

Treatment of cough in children

Coughing in babies, as a rule, causes many unpleasant moments for parents and the child himself. Many groups of mucolytic drugs are prohibited for children under one year of age, since the harm from their use by infants significantly outweighs the benefits. Pediatricians say that expectorant thinners for babies are selected with extreme caution, since uncontrolled self-medication can lead to serious complications in the respiratory tract. Expectorant medications approved for children under one year of age include Gedelix, licorice root syrup, and Pertussin. From six months onwards, babies can also be treated with dry cough syrup. For severe forms of diseases of the pulmonary system in children, an effective remedy is “Lazolvan”, “Bromhexine” syrup, “Ambrobene”.

Rules for determining an effective medicine for children

Only a pediatrician should select a drug to treat a child’s cough, otherwise there is a high risk of harming the child’s health. Many mucolytic drugs are allowed only from the age of two, so parents need to take a responsible approach to treatment and strictly follow the recommendations of children's doctors. Before you start choosing and purchasing a medicine for your baby, you need to show your child to the doctor and listen to his recommendations.

Source: http://www.syl.ru/article/199798/new_mukoliticheskie-sredstva-otharkivayuschie-razjijayuschie-mokrot

The use of mucolytic agents in the treatment of cough

Mocolytic agents dilute sputum and can be used if the patient has a cough accompanied by difficult-to-discharge, viscous and thick sputum. These are one of the basic groups of medications that doctors prescribe during the treatment of productive, (“wet”) cough.

There are certain features of the use and activity of drugs from the group of mucolytics:

  • Clinical effectiveness when using expectorant and mucolytic drugs is observed 5-7 days after starting to use the medications.
  • At the beginning of therapy, patients may notice the effect of “imaginary worsening”.
  • The use of mucolytics is not recommended during the treatment of bedridden patients due to the “flooding effect”.

Mucolytic drugs can be thiol-containing, visicinoids, or proteolytic enzymes.

Indications for use, mechanism of action

Patients often wonder: what is mucolytic action? After entering the bronchial mucus, the action of the active components of the drugs is aimed at the destruction of protein molecules that ensure its viscosity and thickness. There is a decrease in the viscosity of mucus and easier removal from the bronchi area - this is a mucolytic effect.

The use of this group of drugs contributes to:

  1. Inhibition of the formation of bronchial secretions.
  2. Restoration of damaged bronchial mucous membranes.
  3. Rehydration of sputum.
  4. Normalization of the elasticity of lung tissue.
  5. Stimulation of the removal of sputum from the lumens of the bronchial tree.

Mucolytics are included in the group of expectorants and can be used to detect viscous, mucous or mucopurulent sputum that is difficult to separate.

Such medications are used in the complex treatment of diseases affecting the lower respiratory tract:

  • Bronchiectasis.
  • Acute and chronic obstructive bronchitis.
  • Tracheitis.
  • Pneumonia.
  • Bronchial asthma.
  • Bronchiolitis.
  • Cystic fibrosis.

The main feature of drugs in this group is that while the sputum is diluted, the active substances do not contribute to an increase in its volume.

In case of a productive, wet, profuse cough, the prescription of medications whose action is aimed at thinning the sputum is not required. It is also not recommended to combine this group of mucolytics with antitussive drugs.

Classification by active substance

Mucolytics are drugs that help thin sputum.

Modern pharmacology provides the following list of mucolytic drugs:

  • Medicines that help accelerate the removal of sputum based on bromhexidine and ambroxol.
  • Medicines that help reduce mucus formation.
  • Medicines based on acetylcysteine ​​help to influence the quality of viscosity and elasticity of bronchial mucus.

Mucolytic cough suppressants may also contribute to direct and indirect effects.

With direct exposure, rapid destruction of the polymer bonds of mucus, which is located in the bronchi, is observed.

Your doctor may recommend using:

  • Acetylcysteine ​​(ACC), Mucaltin, Mucomista, Mukobene, Fluimucil, infusion of marshmallow root, plantain leaves, coltsfoot, marshmallow.
  • Enzyme preparations that reduce the viscosity of sputum: Trypsin, Chymotrypsin, Ribonuclease, Streptokinase.
  • Carbocysteines: Mucopronta, Mucosola, Broncatara.

If it is necessary to provide an indirect effect, the following may be recommended:

  • Bromhexine: Broxin, Fulpen, Bisolvon, Phlegamine.
  • Ambroxol: Amrosana, Ambrobene, Lasolvana, Medoventa.
  • Antihistamines and anticholinergic drugs that help change the productivity of the bronchial glands.

Patients are advised to refrain from self-medication. If a cough occurs, you should consult a doctor and find out the exact cause of the symptom. A suitable treatment regimen will be prescribed after an in-person examination and a comprehensive examination.

Mucolytics with acetylcysteine

Mucolytic drugs based on acetylcysteine ​​are among the most active. Available in the form of tablets or powders for internal use.

When dissolving the medicine, the manufacturer recommends using glass containers. The drug is taken immediately after the main meal.

The active component is included in the following products:

It is recommended to refrain from using drugs based on acetylcysteine:

  1. During the treatment of patients with bronchial asthma, since there is a risk of bronchospasm.
  2. With exacerbation of stomach and duodenal ulcers.
  3. During treatment of patients under 2 years of age.
  4. When treating pregnant and lactating women.

The combination of acetylcysteine ​​with drugs that include nitroglycerin enhances the vasodilatory effect and antiplatelet properties.

Antibiotics based on cephalosporin, tetracycline and penicillin are recommended to be used no earlier than a few hours after using acetylcysteine.

Mucolytics with bromhexine

Bromhexine helps to liquefy sputum and has a weak antitussive effect. I use the drugs in the treatment of acute and chronic bronchitis, pneumonia, tracheobronchitis.

This active substance is included in the following drugs:

It is recommended to take the tablets orally, after meals, with a sufficient amount of liquid. The duration of use of the medicine is determined by the doctor, taking into account the therapeutic effect and indications for use.

  • Under the influence of Bromhexine and Ambroxol, the processes of production of substances that cover the mucous membranes of the bronchi (surfactant) are activated, which prevent small villi that promote mucous formations from the bronchi from sticking together.
  • Bromhexine enhances the effectiveness of antibiotic therapy.
  • If you use a combination of mucolytics with herbal expectorants, an increase in the positive therapeutic effect is observed.

In order to enhance the mucolytic effect, preparations based on bromhexidine and ambroxol are recommended to be taken with fruit juice.

Mucolytics with carbocisteine

Medicines based on carbocisteine ​​are used in the complex treatment of bronchitis, whooping cough, bronchial asthma, otitis, and sinusitis. Pharmacological activity is similar to acetylcysteine; the active substance is part of the following drugs:

The use of Carbocisteine ​​is permissible in the treatment of patients with a history of bronchial asthma. Unlike drugs that contain acetylcysteine, carbocysteine ​​does not contribute to the development of bronchospasms.

Mucolytics with ambroxol

Bromhexine is a prodrug, and Ambroxol is an active metabolite of Bromhexine.

Ambroxol, like Bromhexine, is a synthetic analogue of the alkaloid vizicine, obtained from the plant Justitia vascularis.

This substance is included in drugs with the following trade names:

  • Lazolvan in the form of tablets and capsules for internal use, solution for inhalation, syrup for adults and children, lozenges for resorption.
  • Neo-Bronchol in the form of lozenges.
  • Flavamed in the form of tablets and solution for internal use.
  • Flavamed Max in the form of effervescent tablets.
  • Ambrosan - tablets for internal use.
  • Ambroxol in the form of tablets and syrup for internal use.
  • Halixol in the form of tablets and syrup for oral administration.
  • Vicks active abromed is a syrup for oral administration.
  • Ambrohexal – syrup, solution, tablets.

It is recommended to refrain from using drugs based on ambroxol when treating patients with gastric ulcers, convulsive syndrome, bronchial motility disorders, large volumes of secretions (due to the risk of developing mucus stagnation in the bronchi), during the 1st trimester of pregnancy and breastfeeding.

Mucolytics with a combined composition

Mucolytics with a combined composition contain several active components that mutually enhance each other's therapeutic effects.

  • Codelac Broncho with thyme is a combined mucolytic with ambroxol, sodium glycyrrhizinate, and liquid thyme extract. Can be used in the treatment of children from 2 years of age. It has an expectorant, antispasmodic and anti-inflammatory effect. Not recommended for use during pregnancy and breastfeeding.
  • Ascoril expectorant is a drug based on bromhexine, salbutamol, guaifenesin, and racementol. Available in syrup form for internal use. The combination of active ingredients with salbutamol prevents and eliminates the development of bronchospasms. This drug is used in the treatment of obstructive bronchitis and bronchial asthma. Among the contraindications are the period of pregnancy and breastfeeding, hypertension, cardiac arrhythmia, the development of decompensated diabetes mellitus, thyrotoxicosis, exacerbation of gastric and duodenal ulcers.

The doctor may also recommend the use of Joset (syrup), cough tablets, Codelac Broncho.

Ribonuclease

One of the expectorants that help thin sputum and have an anti-inflammatory effect are enzyme preparations, for example, Ribonuclease. The active substance is obtained from the pancreas of cattle.

The mechanism of action of enzyme preparations is associated with their ability to:

  • Act only in the area of ​​necrotic tissue and viscous secretions. Such drugs do not demonstrate effectiveness in healthy tissue.
  • Break down peptide bonds in protein molecules.
  • Reduce the viscoelastic properties of sputum.

The use of the drug may cause the development of allergic reactions and irritation of the mucous membranes of the respiratory tract. Due to the high risk of developing bronchospasms, this type of mucolytics is prescribed in rare cases.

Mucolytic drugs are often used in complex treatment of the respiratory system. The selection of medications is carried out strictly individually, taking into account the patient’s age, the nature of the pathological process and the mechanism of pharmacological action of the drug.

Related materials:

Victor Marchione

MD is a respected leader in the fields of smoking cessation and pulmonary medicine. He has more than 20 years of experience in practicing medicine and treating pulmonary diseases such as bronchitis, pneumonia, bronchial asthma and chronic obstructive pulmonary disease (COPD).

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Diseases, consultations, diagnosis and treatment

Expectorant and mucolytic drugs: review of drugs

Increased formation (hypersecretion) of mucus in the respiratory tract accompanies many acute infections, as well as bronchial asthma, chronic obstructive disease and other pulmonary pathologies. In this case, it is necessary to take mucoactive agents. Their main purpose is to improve expectoration of mucus and/or reduce its formation.

Mucoactive drugs are divided according to their mode of action into expectorants, mucoregulators, mucolytics and mucokinetics. You can classify them into other groups, but this approach makes it possible to more accurately select the drug needed for coughing.

A little about sputum formation

Accumulation of mucus due to inflammation of the airway wall

In healthy people, mucus is secreted in normal quantities and is continuously removed by ciliated epithelial cells towards the larynx, and then enters the nasopharynx and is swallowed. Increased mucus secretion in the respiratory system can become a problem, especially if the rate of secretion exceeds the speed of movement of mucus particles by ciliated epithelial cells.

Hypersecretion of mucus is a characteristic sign of acute respiratory infections, as well as bronchial asthma, COPD and chronic bronchitis, bronchiectasis. During inflammation caused by infection, there is an increase in the number and size of so-called goblet cells located in the submucosal glands. Secretory hyperactivity occurs.

Inflammation causes loss of function and destruction of epithelial cilia, changes in the physicochemical properties of the mucous membrane and disruption of the normal composition of sputum. During this process, dead bacteria and immune cells and desquamated epithelium accumulate, forming pus.

Mucus, which forms the basis of sputum, is an oligomer that consists of water and high molecular weight proteins that form a gel. Medicines that change the physical or chemical characteristics of sputum are called mucoactive and, depending on the main effect, are divided into groups.

Expectorants

These medications make it easier to cough up mucus.

Thermopsis

Thermopsis cough tablets are a popular expectorant.

The herb of this plant has a reflex effect when coughing. It moderately irritates the inner wall of the stomach, as a result of which not only gastric, but also bronchial secretion increases reflexively. The amount of sputum increases, it becomes more liquid and is easier to cough up. Thermopsis alkaloids stimulate the respiratory center, activating cough. When consumed in high doses, the vomiting center may also be stimulated.

Thermopsis grass is often used in combination with soda (sodium bicarbonate). This substance additionally stimulates mucus production, thinning phlegm.

Other medicinal plants act in the same way, reflexively enhancing bronchial secretion (licorice, marshmallow). They are used for coughs with difficult to clear sputum due to tracheitis and bronchitis. Their side effect is nausea; these drugs should not be used for gastric ulcers and individual intolerance.

Thermopsis herb is included in the following medicinal products:

  • Amtersol (syrup);
  • Codelac and Codelac Broncho;
  • Codelac Phyto (elixir);
  • dry cough syrup;
  • cough tablets;
  • Thermopsol.

Guaifenesin

This substance reduces the surface tension of sputum and makes it more fluid. In addition, it reduces its adhesive (“sticky”) properties. The viscosity of sputum decreases and it is easier to expectorate.

Medicines containing guaifenesin are prescribed for diseases with a moderate wet cough, late stage tracheitis and mild bronchitis. Side effects include nausea, stomach pain, and diarrhea. Guaifenesin has a mild anxiolytic effect, so it can cause dizziness and drowsiness. Allergic symptoms are also possible.

Medicines with guaifenesin should not be taken if you have a cough with a large amount of sputum, with stomach ulcers, previous gastric bleeding, in children under 2 years of age, or with intolerance. While taking these medications, it is recommended to drink more fluids and do a vibration massage of the chest. Sometimes the metabolic products of this substance cause pink coloration of urine, this is not dangerous. Guaifenesin should not be taken simultaneously with psychotropic drugs and alcohol.

Coldrex Broncho and Tussin syrups contain only guaifenesin. It is also part of multi-component products:

Mucoregulators

Drugs in this group change the amount of sputum produced. These include carbocisteine, anticholinergics, glucocorticoids and macrolide antibiotics.

Carbocisteine

Libexin Muco syrup contains carbocisteine.

This substance has a variety of pharmacological effects:

  • destroys chemical bonds between molecules that form mucus;
  • changes the electrical charge of sputum mucopolysaccharides, activates the production of sialomucins;
  • activates the movement of epithelial cilia;
  • reduces the viscous properties of sputum;
  • improves the release of mucus from the paranasal sinuses;
  • has anti-inflammatory properties.

Carbocisteine ​​is indicated for the production of copious viscous sputum. These are bronchitis, broncho-obstructive syndrome, asthma, bronchiectasis, whooping cough. In addition, it is used in the treatment of sinusitis and inflammation of the middle ear, as well as before bronchoscopy or bronchography.

This substance is well tolerated. Only sometimes, after its administration, there may be disturbances in the functioning of the stomach, loose stools or signs of bleeding. Skin rash or itching is possible.

  • exacerbation of gastric and duodenal ulcers;
  • chronic glomerulonephritis of any etiology in the acute stage;
  • 1st trimester of pregnancy;
  • individual intolerance.

Carbocisteine ​​can be prescribed to children starting from 1 month in the appropriate dosage.

Medicines containing this substance:

  • Bronchobos (syrup and capsules);
  • Libexin Muco (syrup);
  • Fluifort (syrup and soluble granules);
  • Fluditec (syrup).

Anticholinergic drugs (ipratropium bromide), glucocorticoids, and macrolides also have moderate mucoregulatory properties. However, the main effects of these drugs are different, so they are not used for the direct purpose of changing the characteristics of sputum.

Mucolytics

These agents reduce the viscosity of sputum, giving it “fluidity.” They are used if the sputum is too thick.

Acetylcysteine

Acetylcysteine ​​thins mucus

The substance directly affects long molecules and breaks the chemical bonds between them. As a result, the polymer properties of mucus weaken and its viscosity decreases. Acetylcysteine ​​is also active against purulent sputum, which distinguishes it from many other drugs.

The substance has an antioxidant effect, that is, it protects cell membranes from the harmful effects of toxins and metabolic products. It enhances the body's production of glutathione, a substance that actively removes toxins and free radicals.

Acetylcysteine ​​is prescribed for viscous and/or mucopurulent sputum in the following cases:

  • inflammation of the trachea, bronchi, lungs;
  • bronchiectasis;
  • pulmonary atelectasis;
  • cystic fibrosis;
  • asthma;
  • sinusitis.

It can also be prescribed to children starting from 2 years old. Possible side effects:

  • rarely – stomach pathology, diarrhea;
  • rash and itching of the skin, bronchospasm;
  • when used in a nebulizer - severe cough, stomatitis;
  • nose bleed;
  • noise in ears.

Acetylcysteine ​​is contraindicated in cases of exacerbation of gastric and duodenal ulcers, hemoptysis, pregnancy and breastfeeding, and in case of drug intolerance. It is necessary to take a 2 hour break between taking this substance and antibiotics.

List of products with acetylcysteine:

  • Acestin (regular and soluble tablets);
  • Acetylcysteine ​​(powder and soluble tablets);
  • ACC (soluble granules, syrup);
  • ACC 100 (soluble tablets);
  • ACC Inject (solution for deep intramuscular or intravenous administration);
  • ACC Long (soluble tablets);
  • Vicks Active Expectomed (soluble tablets);
  • N-Ac-Ratiopharm (powder and soluble tablets);
  • Fluimucil (solutions for oral administration, for inhalation and injection, soluble granules and tablets).

Dornase alpha

The modern drug Pulmozyme is used as a mucolytic for cystic fibrosis. It is based on a genetically engineered enzyme that cleaves extracellular DNA.

When such an aerosol enters the bronchi and lungs, the viscous, purulent, with altered properties of sputum in cystic fibrosis is broken down and liquefied, which significantly enhances its excretion.

In addition to cystic fibrosis, dornase alfa can be used for bronchiectasis, severe COPD, congenital lung malformations, and pneumonia due to immunodeficiencies.

Side effects of this drug are extremely rare and the frequency is the same as with placebo (a neutral, non-drug). Most patients who experience any adverse effects associated with the use of Pulmozyme can continue to use it. This aerosol is administered using a special device - a jet nebulizer. It is contraindicated only in case of individual intolerance.

Erdostein

Erdomed - a modern cough medicine

This substance is the basis of the drug Erdomed, produced in capsules and soluble granules. Such a mucolytic was synthesized quite recently. In addition to mucolytic and antioxidant properties, it reduces the ability of bacteria to “stick” to the wall of the respiratory organs. The drug is used in the treatment of bronchitis, COPD, bronchiectasis, sinusitis and other conditions with thick sputum. It is especially indicated for use in smokers.

  • age up to 2 years;
  • 1st trimester of pregnancy;
  • for granules – phenylketonuria;
  • homocystinuria;
  • liver or kidney failure;
  • individual intolerance.

Side effects are rare. This is an allergic reaction, nausea, vomiting and loose stools.

Mucokinetics

These drugs are used for obsessive, unproductive coughs to enhance mucus removal and cleanse the bronchi. They act primarily on the cilia of the epithelium, and also reduce the “adhesion” between the mucous membrane and sputum particles. These drugs are ambroxol and bromhexine.

Ambroxol

This remedy makes phlegm liquid and clears the bronchi from it. By acting on glandular cells, ambroxol enhances the production of the liquid part of mucus. Under its influence, the amount of surfactant in the lungs increases, ensuring the expansion of the alveoli. The drug activates the work of epithelial cilia. Cough under its influence decreases slightly.

You can use the medicine from birth. It is well tolerated, only occasionally causing stomach upset or allergies.

Ambroxol is contraindicated in the following cases:

List of ambroxol drugs:

  • Ambrobene (capsules, solution for oral administration and nebulizer, tablets, syrup, solution for intravenous administration);
  • Ambrohexal;
  • Ambroxol;
  • Ambrolor;
  • Ambrosan;
  • Bronchoxol;
  • Bronchorus;
  • Lazolvan;
  • Lazongin;
  • Medox;
  • Neo-bronchol;
  • Remebrox;
  • Suprima-Kof;
  • Thoraxol Solution Tablets;
  • Flavamed;
  • Halixol.

Bromhexine

Bromhexine is a safe cough medicine

Its chemical structure is very similar to ambroxol. It is used to combat viscous sputum in tracheitis, bronchitis, asthma, cystic fibrosis and COPD.

The drug is used for oral administration and nebulizer inhalation. Its effect develops gradually, often only after a few days of use. However, low toxicity and the possibility of use in children of any age make bromhexine a popular mucokinetic drug.

Possible side effects: nausea, stomach discomfort, headache, dizziness, skin rash, sweating, bronchospasm.

The only contraindication is individual intolerance to the drug, which distinguishes it favorably from ambroxol.

List of drugs based on bromhexine:

Multi-component products

For persistent coughs, medications containing several ingredients that mutually enhance the effect are often used.

Essential oils of fennel, anise, oregano, mint, eucalyptus

Dry thermopsis extract

Chlorphenamine (antiallergic component)

Phenylephrine hydrochloride (vasoconstrictor)

Many of these medications are available without a doctor's prescription. Therefore, it is worth studying the specifics of their purpose before purchasing at a pharmacy and choosing the most suitable medicine for yourself. Here we do not dwell on herbal medicine and non-drug methods for treating cough.

Source: http://ask-doctors.ru/otxarkivayushhie-i-mukoliticheskie-preparaty-obzor-sredstv/