Chronic bronchitis mucolytics

Erdosteine is recently introduced mucolytic with unique protective functions for the respiratory tract. It is indicated in the treatment of acute and chronic airway diseases such as bronchitis, rhinitis, sinusitis, laryngopharyngitis and exacerbations of chronic bronchitis. 

Poole PJ, Black PN. Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2003 CD001287. 

N-Acetylcysteine. Mucolytic agents such as IV-acetylcysteine (NAC) have been used by aerosol delivery in an attempt to aid in sputum clearance. Supplied in sufficient quantity, acetylcysteine will help liquefy tenacious secretions and make their clearance easier. A review of studies on the use of NAC in CF concluded the evidence does not support its use, either via nebulizer or by mouth [93]. Intravenous NAC was tested and found not useful in acute respiratory distress syndrome [94]. In one study, patients with chronic bronchitis who took oral NAC had fewer exacerbations and better symptom improvement than did control patients [95], In the United States, there is no use of NAC by any route for chronic bronchitis. These data need more examination and further study before any such use might be considered. A newer mucolytic agent, nacystelyn, has been developed for delivery via a dry powder inhaler. Deposition in adults and children with CF was 16% and 23%, respectively [94]. 

Mucolytics should be used with caution in patients with a history of peptic ulcer because they may reduce the amount of mucus in the stomach. Steam inhalation may be as effective as a mucolytic in chronic bronchitis. 

Mucolytlcs - The problems presented by thick, tenacious sputum are central to the treatment of chronic bronchitis. There Is an Important need for effective mucolytlcs, particularly orally effective congiounds. The mucolytic-expectorant bromhexine (I), N-cyclohexyl-N-methyl-(2-amlno-3,5-dlbromobenzyl)ammonium chloride, was shown earlier to fragment the acid mucopolysaccharide fibers In sputum, thereby decreasing sputum viscosity. 

Kory, et al. reported that the pronounced mucolytic action of N-acetylcysteine (II) in patients with chronic bronchitis was not lessened... 

Mucolytic Adjuvant therapy for abnormal, viscid, or inspissated mucus secretions in chronic bronchopulmonary disease (chronic emphysema, emphysema with bronchitis, chronic asthmatic bronchitis, tuberculosis, bronchiectasis, primary amyloidosis of lung) acute bronchopulmonary disease (pneumonia, bronchitis, tracheobronchitis) pulmonary complications of cystic fibrosis tracheostomy care pulmonary complications associated with surgery use during anesthesia posttraumatic chest conditions atelectasis due to mucus obstruction diagnostic bronchial studies (bronchograms, bronchospirometry, bronchial wedge catheterization). 

Mucous airway obstruction. Expectorants are meant to promote clearing of bronchial mucus by a liquefying action that involves either cleavage of mucous substances (mucolytics) or stimulation of production of watery mucus (e.g., hot beverages). Whether mucolytics are indicated in the common cold and whether expectorants such as bromohexine or ambroxole effectively lower viscosity of bronchial secretions may be questioned. In clinical studies of chronic obstructive bronchitis (but not common cold infections), N-acetylcysteine was shown to have clinical effectiveness, as evidenced by a lowered incidence of exacerbations during chronic intake. 

Parvolex ) is used a MUCOLYTIC agent, which reduces the viscosity of sputum, so can be used as an expectorant in patients with disorders of the upper respiratory airways, such as chronic asthma and bronchitis. It is also used orally to treat abdominal complications associated with cystic fibrosis, and locally in the eye to increase lacrimation and mucus secretion. It is also used intravenously as an antidote in paracetamol poisoning. 

Acetylcysteine decreases thickness of mucous secretions in lung. As a mucolytic agent, acetylcysteine splits disulfide linkages between mucoprotein molecular complexes, decreasing their viscosity. It is used as an adjunct therapy in emphysema with bronchitis, chronic asthmatic bronchitis, mberculosis, bronchiectasis, primary amyloidosis of the lung, pneumonia, and tracheobronchitis. In addition, it is used in pulmonary complications of cystic fibrosis and those associated with anesthetics, surgery, or care following tracheostomy. 

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