Mucoactive agent

Mucoactive agents are a class of drugs which aid in the clearance of mucus from the upper and lower airways, including the
lungs, bronchi, and trachea. Mucoactive drugs include expectorants, mucolytics, mucoregulators, and mucokinetics. These
medications are used in the treatment of respiratory diseases that are complicated by the oversecretion of mucus. The drugs can
be further categorized by their mechanism of action.[1][2]

Contents
Mechanism of action
Mucoactive drugs
References
External links

Mechanism of action
Expectorants – increase airway water or the volume of airway secretions[3]
Mucolytics – thin (reduce the viscosity of) the mucus[2]
Mucokinetics – increase transportability of mucus by cough[2]
Mucoregulators – suppress underlying mechanisms of mucus hypersecretion[2]
In general, clearance ability is hampered by the bonding to surfaces (stickiness), and by the viscosity of mucous secretions in the
lungs. In turn, the viscosity is dependent upon the concentration of mucoprotein in the secretions.

Expectorants and mucolytic agents are different types of medication, yet both are intended to promote drainage of mucus from the
lungs.

An expectorant (from the Latin expectorare, to expel or banish) works by signaling the body to increase the amount or hydration
of secretions, resulting in more yet clearer secretions and as a byproduct lubricating the irritated respiratory tract.[4]

One expectorant, guaifenesin, is commonly available in many cough syrups and also as long release tablets. Often the term
"expectorant" is incorrectly extended to any cough medicine, since it is a universal component. Mucolytics can dissolves thick
mucus and are usually used to help relieve respiratory difficulties. They do this by breaking down the chemical bonds between
molecules in the mucus.[5] This in turn can lower the viscosity by altering the mucin-containing components.

Alternatively, attacking the affinity between secretions and the biological surfaces is another avenue, which is used by abhesives
and surfactants.

Any of these effects could improve airway clearance during coughing.

An expectorant increases bronchial secretions and mucolytics help loosen thick bronchial secretions. Expectorants
reduce the thickness or viscosity of bronchial secretions thus increasing mucus flow that can be removed more
easily through coughing. Mucolytics break down the chemical structure of mucus molecules. The mucus becomes
thinner and can be removed more easily through coughing.

— Adams, Holland, & Bostwick, 2008, p. 591

Mucoactive drugs
Many mucoactive drugs are available, including sodium citrate or potassium citrate, potassium iodide, guaifenesin, tolu balsam,
vasaka, and ammonium chloride.

Mucolytic drugs available include acetylcysteine, ambroxol, bromhexine, carbocisteine, erdosteine, mecysteine,[5] and dornase
alfa.

References
1. Balsamo, R.; Lanata, L.; Egan, C. G. (2010). "Mucoactive drugs". European Respiratory Review. 19 (116): 127–
33. doi:10.1183/09059180.00003510 (https://doi.org/10.1183%2F09059180.00003510). PMID 20956181 (https://
www.ncbi.nlm.nih.gov/pubmed/20956181).
2. Rogers, D. F. (2007). "Mucoactive agents for airway mucus hypersecretory diseases". Respiratory Care. 52 (9):
1176–93, discussion 1193–7. PMID 17716385 (https://www.ncbi.nlm.nih.gov/pubmed/17716385).
3. Rubin, Bruce K. (2006). "The pharmacologic approach to airway clearance: Mucoactive agents" (https://www.scie
ncedirect.com/science/article/abs/pii/S1526054206002454?via%3Dihub). Paediatric Respiratory Reviews. 7
(Supplement 1): S215–S219. doi:10.1016/j.prrv.2006.04.198 (https://doi.org/10.1016%2Fj.prrv.2006.04.198).
Retrieved 21 August 2019.
4. "Definition of Expectorant" (http://www.medicinenet.com/script/main/art.asp?articlekey=24354). MedicineNet. 13
May 2016. Retrieved 4 January 2018.
5. "NCATS Inxight: Drugs — MECYSTEINE HYDROCHLORIDE" (https://drugs.ncats.io/ginas/app/substance/dbff84
e7). drugs.ncats.io. Retrieved 29 May 2019.

Adams, Michael; Holland, Leland Norman; Bostwick, Paula Manuel (2016). Pharmacology for Nurses: A
Pathophysiologic Approach (5 ed.). Pearson Education. p. 960. ISBN 978-0134255163.

Rubin, Bruce K (1 July 2007). "Mucolytics, Expectorants, and Mucokinetic Medications" (http://rc.rcjournal.com/co
ntent/52/7/859.short). Respiratory Care. 52 (7).

External links
National Center for Biotechnology Information (https://www.ncbi.nlm.nih.gov/books/NBK57832/)

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This page was last edited on 28 August 2019, at 05:48 (UTC).

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