Aerosolized detergents and mucolytic agents in the treatment of stable chronic obstructive pulmonary disease.

Abstract

The literature concerning clinical experience with mucolytic agents in patients with stable COPD, and the effects of these agents on bronchial secretions in vitro was reviewed. Aerosols containing detergents exert little mucolytic action, and their value for patients with stable COPD has not been established objectively; they may be of subjective benefit by reducing or replacing loss of H2O from the upper airways for patients breathing dry air. For patients with COPD stabilized in a treatment program that includes bronchodilator, adequate H2O intake, bronchial toilet, and antibiotic drugs when necessary, controlled clinical studies indicated that adding routine administration of aerosolized mucolytic agent, such as acetylcysteine, is of neither subjective nor objective benefit. When resistance to removal by cough or obstruction due to thick tenacious secretions or mucus plugs continues to be troublesome, a mucolytic agent such as acetylcysteine that will attack the gel structure and loosen the plugs can b...