Mucolytics: a list of drugs for children and adults

In acute respiratory infections, we often encounter such an unpleasant phenomenon as coughing. It is exhausting and bothersome, makes breathing difficult and significantly reduces the quality of life. It is very important for the doctor to determine what type of cough the patient has: dry or wet. The first type is considered unproductive and is characterized by difficulty in spitting. Wet cough is called productive and shortens the period of recovery of the patient. Having discovered a dry type of cough in the patient, doctors often prescribe drugs that dilute the viscous mucous secret that forms in the respiratory organs. Due to the increased density of this mucus, the patient experiences difficulties with sputum discharge or expectoration.

What are mucolytics?

In order to help a patient with a dry cough, the doctor usually prescribes mucolytics. The list of drugs included in this group is quite extensive. According to the method of influence on the human body, these medicines can be divided into three groups:

• Mucoregulating substances. They affect the volume of secreted mucous secretion. This group includes glucocorticosteroids, M-holinoblokatory and carbocysteine.
• Mukokinetics are drugs that significantly improve mucus escape. These include ambroxol, bromhexine, etc.
• Direct mucolytics. These substances contribute to the liquefaction of the mucous secretion by reducing its viscosity. Mucolytics include proteolytic enzymes, acetylcysteine, etc.

Various sputum liquefaction mechanisms

If we consider the mechanism by which molecules of acid mucopolysaccharides of the mucosal secretion of a person can be destroyed with the help of preparations, two main ways can be distinguished: the enzyme method and the non-enzymatic pathway. In the first case, enzymes destroy protein bonds, and in the other, disulfide bridges in sputum molecules.

Classification by main active ingredient

All these preparations are combined according to the international classification of medicines ATX or ATS under the code R05CB "Mucolytics". The list of the main active substances also provides a certain alphabetic and numerical designation:

• R05CB01 is acetylcysteine.
• R05CB02 is bromohexine.
• R05CB03 is carbocysteine.
• R05CB06 is ambroxol.
• R05CB10 - preparations with a combined composition.
• R05CB13 - Dornase alfa (deoxyribonuclease).

The only doctor who decides which mucolytics to prescribe to a particular patient is the doctor. This appointment, he does only after a thorough examination and guided by the results of the relevant analyzes. Let's take a closer look at how each active substance included by pharmacists in the R05CB group works.

Mucolytics with acetylcysteine

Acetylcysteine effectively helps to thin phlegm, and therefore was included in the mucolytics group. The list of preparations with this active substance includes about two dozen names of medicines of various forms. Acetylcysteine is characterized by the following mechanisms of action:

• It has in its molecule sulfhydryl groups of reactive orientation, which act destructively on the disulfide compounds of mucopolysaccharides, because of which mucus is characterized by increased viscosity. As a result, sputum is diluted and excreted from the body more easily.
• This substance reduces activity and reduces the number of pathogens that are on the mucosa of the respiratory organs.
• It has the properties of an antioxidant. Sulfhydryl groups react with free radicals and oxygen metabolites and excrete them from the body. Thus, acetylcysteine has an anti-inflammatory effect and releases the body from toxic substances, greatly facilitating the patient's condition.

From the preparations containing as active substance acetylcysteine, it is possible to note:

• "Mukobene" - tablets; 100, 200 or 600 mg.
• "Mukomist" - a solution in ampoules, 20% for topical application and inhalation.
• "Mukonex" in the form of granules, 0.1 g for the preparation of syrup.
• "Fluimucil" in the form of granules, 100 and 200 mg; Tablets for obtaining an effervescent drink, 600 mg.
• "ACTS" in the form of tablets for the preparation of fizzy drink - 100, 200, 600 mg; Injection for 300 mg / 3 ml in ampoules; Granules for obtaining a solution inside, 100, 200 mg.
• "Acetylcysteine" in powder form, 200 mg; Solution for injection, 10%; Solution for the implementation of ngalations, 20%;
• "Acetin" - tablets for internal administration, 100, 200, 600 mg; Tablets for obtaining an effervescent drink, 200 and 600 mg.

Acetylcysteine and drugs with it are contraindicated for children under 2 years (and some up to 6 years), pregnant and lactating women, people with peptic ulcer diseases in the acute stage. There may be side effects in the form of headache, stomatitis, drowsiness and noise in the ears, there are less often GI disorders, allergies, tachycardia. Acetylcysteine can not be drunk with antitussive drugs. It also enhances the effect of nitroglycerin and inhibits the absorption of antibiotics.

Mucolytics with bromhexine

Drugs containing this substance as an active ingredient are often prescribed for coughing, and are positioned as mucolytics. The list of drugs is limited to five pharmaceutical products. Getting into the human body, bromheksin acts as follows:

• Reduces the viscosity of bronchial secretions through depolarization of mucus polysaccharides;
• Stimulates bronchial mucosa cells, which secrete polysaccharides of neutral type;
• Promotes the formation of surfactant;
• Produces an expectorant effect;
• Inhibits cough reflex.

Mucolytics, listed below, contain bromhexine as the main active ingredient. These include:

• Solvyn - internal solution, 4 mg / 5 ml; Tablets for oral use, 8 mg.
• "Bromhexine" in the form of a solution, 4 mg / 5 ml; Syrup, 4 mg / 5 ml; Tablets, 8 mg.

Mucolytic drugs containing bromhexine are contraindicated in individuals with intolerance to this component, and children up to 6 years of age. They can cause indigestion, headache, increased sweat, skin rash and bronchospasm. Pregnant and lactating women are rarely prescribed medications with bromhexine.

Preparations with carbocysteine

This drug is also included in the Mucolytics group. The list of drugs with carbocysteine includes about ten names, but all of them have the same pharmaceutical effect:

• Reduce the content of neutral and increase the production of acid glycopeptides, normalize their proportion;
• Reduce viscosity and regulate the elasticity of sputum;
• Regenerate the mucous membranes of the respiratory organs and restore its normal structure;
• Increase the local specific resistance factor lgA;
• Normalize the isolation of sulfhydryl groups;
• Activates the activity of the ciliary epithelium of the bronchi.

Very often, patients are prescribed such mucolytics. The list of drugs and preparations containing carbocysteine is given below:

• "Libexin Muko" in the form of a syrup, 50 mg / ml.
• "Mucodin" in the form of capsules, 125 mg; Syrup for children 125 mg / 5 ml and 250 mg / 5 ml.
• "Carbocysteine" in the form of syrup 250 mg / 5 ml and 125 mg / 5 ml (for children); Capsules, 375 mg.
• "Fluviert" in the form of granules to obtain a suspension, 2.7 mg; Syrup, 90 mg / l; Syrup 2% (for children) and 5%.

Carbocysteine mucolytics, drugs and preparations described above can not be taken in case of allergies to the main component, as well as ulcers, irregular functioning of the liver, glomerulonephritis in acute form, cystitis, pregnancy and lactation. Preparations in the form of capsules are contraindicated for children under 12 years, and in the form of syrup - up to 2 years. Mucolytic drugs from cough on the basis of carbocysteine can trigger digestive disorders and allergic manifestations.

Medications with ambroxol

These drugs are the most popular among patients. Ambroxol has the following effects on the human body:

• Reduces the viscosity and adhesion of sputum;
• Facilitates the escape of mucus from the respiratory tract;
• Activates the work of serous cells of the glandular tissue of the bronchial mucosa;
• Stimulates the production of enzymes that destroy the structure of polysaccharides of sputum;
• Actively promotes surfactant products;
• Stimulates the work of the cilia of the bronchi and prevents them from sticking together.

Due to the presence of these factors, Ambrokol was included in the group "Mucolytics". The list of drugs containing this component is very extensive. Here are the most common drugs with ambroxol:

• "Lazolvan" - tablets for resorption, 20 mg; Pastilles, 15 mg; Solution, 7.5 mg / ml; Syrup 15 and 30 mg / 5 ml; Tablets, 30 mg.
• "Khaliksol" - in the form of syrup, 30 mg / 10 ml and tablets, 30 mg.
• "Medox" - in the form of syrup, 15 mg / 5 ml and tablets, 30 mg.
• "Dephlegmine" - in the form of drops for oral administration, 0.75% and tablets, 30 mg;
• "Suprima-kof" - in the form of tablets, 30 mg.
• "Mukobron" in the form of tablets, 30 mg.
• "Bronchovern drops" is a solution for internal administration, 7.5 mg / ml.
• "Ambrogen" - in the form of capsules, 75 mg; Solution for injection, 7.5 mg / ml; Syrup, 15 mg / 5 ml; Tablets, 30 mg.
• "Ambrohexal" - in the form of capsules, 75 mg; Solution for inhalation and ingestion, 7.5 mg / ml; Syrup 3 and 6 mg / ml and tablets, 30 mg.
• "Ambroxol" - in the form of syrup, 3 and 6 mg / ml; Tablets, 30 mg and capsules, 75 mg.
• "Ambrolap" - in the form of capsules, 75 mg; Syrup, 15 mg / 5 ml; Tablets, 30 mg; Solution for internal administration and for inhalations, 7.5 mg / ml.
• "Ambrosan" - in the form of tablets, 30 mg.
• "Ambrosol" - in the form of syrup 0,3 and 0,6 g / 100 ml.
• "Remebroks" in the form of a syrup of 30 mg / 5 ml.
• "Ambrotard 75" -in the form of capsules, 75 mg.
• "Flavamed" - in the form of a solution for oral administration, 15 mg / 5 ml and tablets, 30 mg.
• "Bronchoval" - tablets, 30 mg; Syrup, 15 mg / 5 ml.

Depending on the form of release of the drug, there are contraindications to taking medications on the basis of ambroxol. Such mucolytics for children under 2 years will only work if the dosage of the active substance does not exceed 3 mg / ml, usually a syrup or solution. Tablets can not be drunk to patients under the age of 6, capsules - up to 14 years. Also, if the patient has an individual intolerance to ambroxol, these mucolytics can not be prescribed. Among the side effects of the drug - digestive disorders, increased mucus from the nose, difficulty urinating, allergic reactions. In pregnancy, as a rule, ambroxol is not prescribed in the first trimester, and in later terms - only on the advice of a doctor.

Mucolytics with a combined composition

These medicines contain several active substances that differ in their activity, which ensure the liquefaction of phlegm, therefore they were included in the typology of "Mucolytics". With a dry cough, a list of drugs prescribed by a doctor from the list described earlier in the article can be supplemented with the following medicines:

• "Sinupret" is a remedy with plant components. Contains in the root of gentian, flowers of primrose and elder, grass sorrel and verbena. The drug is in the form of tablets and alcohol solution. The complex of active substances contributes to the effective removal of mucus from the nasal sinuses and upper respiratory tract. Both dosage forms should not be taken to children under 6 years of age and people with lactase deficiency, and if there is an allergy to the components of the medicine.
• Rinicold Broncho is a drug that has three main active ingredients: ambroxol (15 mg), chlorphenamine (2 mg), phenylephrine (5 mg) and guaifenesin (100 mg). As a result of taking this syrup, the sputum viscosity in the bronchi decreases , expectoration is eased, lacrimation is eliminated, the itching sensation in the eyes and nose is observed, the edema and hyperemia of the mucous tissues of the respiratory system decrease. The drug is contraindicated in cases of convulsions, atherosclerosis, hypertension, diabetes, thyrotoxicosis, pheochromocytoma, closed type glaucoma, ulcer, prostate adenoma, glucose-6-phosphate dehydrogenase insufficiency, pregnancy and lactation period, children under 6 years old, allergy to components. You can not drink this syrup with beta-adrenoblockers, tricyclic antidepressants, MAO inhibitors, and with drugs containing the same active substances as Rinicold Broncho.

Ribonuclease for the treatment of dry cough

Mucolytics usually prescribed by doctors with a dry cough, the list of which was presented earlier, can be attributed to drugs with traditional and tested time. A completely new and modern way of getting rid of viscous sputum in respiratory organs is the use of ribonuclease or dornase alpha. This substance is a genetically engineered product, an analogue of the natural human enzyme, which is responsible for the cleavage of extracellular DNA.

In the presence of a patient with cystic fibrosis, which is characterized by an acute infectious process, an accumulation of a purulent secret with high viscosity is observed. As a result, the function of external respiration is disturbed in patients. In a purulent secret, a large amount of extracellular DNA is contained. These particles are released from decaying leukocytes, formed as a response mechanism for infection, and have a high viscosity. Ribonuclease hydrolytically cleaves sputum DNA and, as a result, mucus liquefies.

Dornase alpha is a part of the preparation "Pulmozim", which is available in the form of a solution for inhalation. The active substance content is 2.5 mg / 2.5 ml. This drug is successfully used in cystic fibrosis, as well as chronic lung diseases: bronchiectatic disease, COPD, congenital malformations in children, pneumonia, respiratory damage of immunodeficiency.

Pulmozym has few contraindications. The drug should not be given to pregnant and lactating women, or children under 5 years of age. Side effects of this drug are rare and can manifest as acute lymphatic leukemia, aplastic anemia, epilepsy, migraine, conjunctivitis, disequilibrium, tachycardia, cardiac arrest, bradycardia, pneumonia, bronchospasm, digestive disorders, allergic dermatitis, Quincke's edema, disorders Pregnancy and delivery, chest pain, weakness.

Treated promptly and correctly

In this article the question was considered: "What preparations are mucolytics?" The list of the most common drugs of this group was named. It should be specially noted that the purpose of the drug, its dosage, as well as recommendations for the duration of the course of treatment and the possibility of replacing the drug with an analogue - these are issues that are in the competence of only a medical specialist after a thorough diagnosis of the patient. Self-medication in this situation can be not only unproductive, but also can lead to unpredictable consequences: from side effects of drugs to the development of chronic diseases. Therefore, if you have symptoms of ailment, do not delay the visit to the doctor. Be healthy!