Mucolytic drug therapy

The mucolytic acetylcysteine may be used as part of the treatment of bronchopulmonary diseases such as emphysema It is primarily given by nebulization but also may be directiy instilled into a tracheostomy to liquefy (thin) secretions. The mucolytic drugs are effective as adjunctive therapy in chronic bronchopulmonary diseases, such as chronic emphysema, emphysema with... 

Poole P J, Black P N 2001 Oral mucolytic drugs for exacerbations of chronic obstructive pulmonary disease. British Medical Journal 322 1271-1274 Rees P J, Dudley F1998 Oxygen therapy in chronic lung disease. British Medical Journal 317 871-874 Rees P ], Dudley F1998 Provision of oxygen at home. 

Discuss ways to promote an optimal response to therapy, how to manage common adverse reactions, and important points to keep in mind when educating the patient about the use of an antitussive, mucolytic, or expectorant drug. 

Aerosol preparations of drugs are most commonly used for the treatment of diseases involving airway obstruction, namely bronchodilators and antiinflammatory agents in asthma, bronchitis, and emphysema. Other uses of aerosol therapies include mucolytics (for decreasing the thickness or viscosity of mucus in diseases involving abnormal mucus secretion, e.g., pneumonia,... 

The drug is usually employed as adjuvant therapy specifically in bronchopulmonary disorders when mucolysis is to be accomplished. It is, however, believed that the sulphhydryl functional moiety present in the molecule helps to open the disulphide bondages in the mucous whereby the viscosity is lowered. Importantly, the mucolytic activity of the drug is directly associated with the pH and an appreciable mucolysis takes place within a pH range of 6 and 9. 

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