mucoactive agent

Mucoactive agents—expectorants—include mucolytics, secretolytics and mucokinetics (also called secretomotorics) {{cite journal|last=Rubin|first=Bruce K.|date=2006|title=The pharmacologic approach to airway clearance: Mucoactive agents|journal=Paediatric Respiratory Reviews|volume=7|issue=Supplement 1|pages=S215–S219|doi=10.1016/j.prrv.2006.04.198|pmid=16798570}}

• Mucolytics: thin (reduce the viscosity of) mucus
• Secretolytics: increase airway water or the volume of airway secretions
• Mucokinetics: increase mucociliary transport (clearance) and transportability of mucus by cough
• Mucoregulators: suppress underlying mechanisms of mucus hypersecretion

Alternatively, attacking the affinity between secretions and the biological surfaces is another avenue, which is used by abhesives and surfactants.{{citation needed|date=May 2019}}

Any of these effects could improve airway clearance during coughing.{{citation needed|date=May 2019}}

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.

Mucolytics, secretolytics and secretomotorics are different types of medication, yet they 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 lubricating the irritated respiratory tract.{{cite web

| url=http://www.medicinenet.com/script/main/art.asp?articlekey=24354

| title=Definition of Expectorant

| date=2016-05-13

| publisher=MedicineNet

| access-date=2018-01-04

| archive-date=11 August 2020

| archive-url=https://web.archive.org/web/20200811092700/https://www.medicinenet.com/script/main/art.asp?articlekey=24354

| url-status=live

}}

One mucoactive agent, guaifenesin, has anxiolytic and muscle-relaxing properties. It is commonly available in cough syrups and also as sustained-release tablets.

Mucolytics can dissolve 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.{{cite web |title=NCATS Inxight: Drugs – MECYSTEINE HYDROCHLORIDE |url=https://drugs.ncats.io/ginas/app/substance/dbff84e7 |website=drugs.ncats.io |access-date=29 May 2019 |archive-date=29 May 2019 |archive-url=https://web.archive.org/web/20190529161253/https://drugs.ncats.io/ginas/app/substance/dbff84e7 |url-status=dead }} This in turn can lower the viscosity by altering the mucin-containing components.{{citation needed|date=May 2019}}

{{quote|

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}}

• Thiols
• acetylcysteine
• mesna
• Thioesters
• carbocisteine
• erdosteine
• mecysteine
• Bromhexine-like
• ambroxol
• bromhexine
• DNAse
• dornase alpha
• Irritative secretolytics
• ammonium chloride (not believed to work by the FDA)United States Food and Drug Administration: [https://web.archive.org/web/20030915182250/http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?FR=310.545 Code of Federal Regulations, Title 21, Volume 5, April 1, 2009]
• Citrates
• potassium citrate
• sodium citrate (not believed to work by the FDA)
• Iodides
• Potassium iodide
• Plant-derived compounds or extracts
• guaifenesin (does not work in upper respiratory track infections){{cite journal | vauthors = Hoffer-Schaefer A, Rozycki HJ, Yopp MA, Rubin BK | title = Guaifenesin has no effect on sputum volume or sputum properties in adolescents and adults with acute respiratory tract infections | journal = Respiratory Care | volume = 59 | issue = 5 | pages = 631–636 | date = May 2014 | pmid = 24003241 | doi = 10.4187/respcare.02640 | doi-access = free }}{{cite journal | vauthors = O'Connell OJ | title = Is extended-release guaifenesin no better than a placebo? | journal = Respir Care | volume = 59 | issue = 5 | pages = 788–9 | date = May 2014 | pmid = 24789023 | doi = 10.4187/respcare.03319 | url = }}
• terpin hydrate (not believed to work by the FDA)
• tolu balsam (not believed to work by the FDA)
• Justicia adhatoda extracts

{{reflist}}

• {{cite book

| title=Pharmacology for Nurses: A Pathophysiologic Approach

| first1=Michael

| last1=Adams

| first2=Leland Norman

| last2=Holland

| first3=Paula Manuel

| last3=Bostwick

| publisher=Pearson Education

| year=2016

| edition=5

| pages=960

| isbn=978-0134255163}}

• {{cite journal

| title=Mucolytics, Expectorants, and Mucokinetic Medications

| first=Bruce K

| last=Rubin

| journal=Respiratory Care

| date=2007-07-01

| volume=52

| issue=7

| url=http://rc.rcjournal.com/content/52/7/859.short}}

• [https://www.ncbi.nlm.nih.gov/books/NBK57832/ National Center for Biotechnology Information]

{{Cough and cold preparations}}

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Category:Pulmonology