Mucolytic Drugs Research Articles

Clinical characteristics and factors associated with mucus plugs under bronchoscopy in children hospitalized for acute asthma attack.

To describe clinical characteristics of hospitalized children with acute asthma attacks complicated with mucus plugs and to investigate the factors associated with mucus plugs in asthma children. This retrospective study analyzed hospitalized children and adolescents with acute asthma attacks from January 2016 to December 2021. The demographic information and characteristics were collected. Subjects were categorized into the mucus plug group and the control group based on the bronchoalveolar lavage results. The Logistic regression analyses were utilized to assess the relative factors associated with mucus plugs. All data were analyzed using SPSS 22.0. This study included 242 individuals. Out of the 151 subjects who underwent bronchoscopy, 62.9% were classified in the mucus plug group and 37.1% in the control group. The subjects with dyspnea had a higher proportion in the mucus plug group (52.6% vs. 26.8%). The serum total IgE level of the mucus plug group was lower than the control group. The proportion of subjects who were diagnosed with asthma for the first time during hospitalization (87.4% vs. 76.8%) and combined with respiratory infection (91.6% vs. 82.1%) in the mucus plug group might be higher than that in the control group. More subjects in the mucus plug group were administered systemic glucocorticoid, magnesium sulfate, aminophylline, and mucolytic drugs after hospitalization. In multivariable analysis, diagnosed with asthma for the first time during hospitalization (OR = 4.404; 1.101-17.614), dyspnea (OR = 4.039; 1.306-12.496), and cesarean (OR = 0.274; 0.092-0.812) might be associated with mucus plug in children hospitalized for an acute asthma attack. While our retrospective study suggests that some clinical features of children hospitalized with asthma who have mucus plugs differ from those without, further studies are required.

N-acetylcysteine – a drug for basic and symptomatic therapy of chronic bronchitis/chronic obstructive pulmonary disease

Prevention and successful treatment of the disease exacerbations are crucial for patients with chronic bronchitis (CB) and chronic obstructive pulmonary disease (COPD). At present, a sufficient number of efforts are being made to improve both prevention of exacerbations in patients with stable disease progression and treatment of the exacerbations. According to international and domestic recommendations, mucolytic drugs are among the key therapies for both bronchitis phenotype of COPD and chronic bronchitis, the main clinical manifestation of which is a long-term productive cough. The aim of the review is to analyze modern literature data that reflect the role of N-acetylcysteine (NAC) in prevention of exacerbations during the stable course and treatment of exacerbations of chronic bronchitis and COPD.

Cystic Fibrosis: A Review of Current Knowledge, Treatment Methods and Diagnostics

Introduction: Cystic fibrosis (CF) is an autosomal recessive genetic disease caused by a mutation in the CFTR gene. Characteristic symptoms include persistent lung infection, pancreatic insufficiency, and elevated sweat chloride, although many patients have mild or atypical symptoms. Diagnosis of CF is based primarily on the detection of genetic and/or functional abnormalities in the CFTR gene. Treatment includes pancreatic enzyme replacement therapy, mucolytic drugs, respiratory physiotherapy, and antibiotic therapy. Purpose of the work: This study aims to review and characterize the clinical and pathophysiological aspects of cystic fibrosis. Materials and methods: A comprehensive analysis of research papers available on PubMed, Google Scholar, Web of Science, Embase and Scopus was undertaken using the searchterms encompassing the following keywords: Cystic fibrosis, CFTR, Chloride Channels, Lung Inflammation, Diagnosis, Gene therapy, Treatment. Results: Cystic fibrosis is the most common, multisystem, life-threatening recessive disease in the white race. Although many organs are affected, the leading cause of morbidity and mortality is lung disease. Treatment requires pharmacotherapy, extensive physiotherapy, and nutritional support. In recent years, there has been significant progress in the diagnosis and treatment of cystic fibrosis, and the average survival has increased from a few to almost 50 years.

Mucolytic Drugs Ambroxol and Bromhexine: Transformation under Aqueous Chlorination Conditions.

Bromhexine and ambroxol are among the mucolytic drugs most widely used to treat acute and chronic respiratory diseases. Entering the municipal wastewater and undergoing transformations during disinfection with active chlorine, these compounds can produce nitrogen- and bromine-containing disinfection by-products (DBPs) that are dangerous for aquatic ecosystems. In the present study, primary and deep degradation products of ambroxol and bromhexine obtained in model aquatic chlorination experiments were studied via the combination of high-performance liquid and gas chromatography with high-resolution mass spectrometry. It was shown that at the initial stages, the reactions of cyclization, hydroxylation, chlorination, electrophilic ipso-substitution of bromine atoms with chlorine, and oxidative N-dealkylation occur. Along with known metabolites, a number of novel primary DBPs were tentatively identified based on their elemental compositions and tandem mass spectra. Deep degradation of bromhexine and ambroxol gives twenty-four identified volatile and semi-volatile compounds of six classes, among which trihalomethanes account for more than 50%. The specific class of bromhexine- and ambroxol-related DBPs are bromine-containing haloanilines. Seven of them, including methoxy derivatives, were first discovered in the present study. One more novel class of DBPs associated with bromhexine and ambroxol is represented by halogenated indazoles formed through dealkylation of the primary transformation products containing pyrazoline or tetrahydropyrimidine cycle in their structure.

Sources of Cysteine-Based Pharmaceutical Drugs and Their Halal Aspects in Pharmaceutical Product Development

Indonesia is the country with the largest Muslim population in the world, so supplements and medicines consumed must be halal (permissible in Islamic law). Cysteine is an essential amino acid that is crucial to human biological functions. Cysteine can be used as a mucolytic agent to help thin mucus in respiratory diseases such as bronchitis or chronic obstructive pulmonary disease (COPD). It also serves as an antidote to acetaminophen for detoxification purposes or as an antidote to counteract paracetamol (acetaminophen) overdose, a commonly used drug to relieve pain and reduce fever. Additionally, it functions as a supplement. This research aims to comprehensively review the sources of cysteine, its production, and its use in pharmaceuticals, as well as the opinions of scholars regarding the halal aspects that need to be considered in developing pharmaceutical products containing cysteine. The methods employed include searching through references from research articles obtained from Google Scholar, ScienceDirect, NCBI, Elsevier, and the Qur'an, Hadiths, and other Islamic literature sources. The compound structures are depicted using the ChemSketch tool from ACD/Labs. Mucolytic and acetaminophen drugs, such as acetylcysteine, can be derived from both animal and plant sources through chemical and non-chemical separation processes. Cysteine is generally a precursor for the synthesis of acetylcysteine. Cysteine sourced from specific organs, such as pig hair, has differing opinions among various scholars regarding its permissibility. However, the prevailing view and fatwa tend to lean towards its prohibition, depending on the source, process, and urgency of its use.

Возможности противовоспалительной терапии в лечении пациентов с аденоидитом

The search for new ways to treat adenoiditis in children is relevant and in demand. Existing therapeutic options (eliminationirrigation therapy, topical antimicrobials, mucolytic drugs) in some cases (with a prolonged course of inflammation in the pharyngeal tonsil, in the presence of concomitant otorhinolaryngological or infectious pathology) have a limitation on the duration of course admission and require the search for new treatment regimens. Promising in this regard is the inclusion of antiinflammatory drugs in the treatment of patients with inflammation of the pharyngeal tonsil. Patients and methods. We observed 2 groups of patients (main (n = 52) and comparison (n = 20)) with signs of inflammation of the pharyngeal tonsil (adenoiditis). Patients of the main group were additionally prescribed ammonium glycyrrhizinate (Reglisam) in an age-appropriate dosage in accordance with the instructions for use for 30 days in the treatment regimen. On the 1st, 7th and 30th days of therapy, all patients underwent endoscopy of the nasal cavity and nasopharynx, assessment of complaints and symptoms on a 10-point visual analog scale (VAS), PCR-diagnosis of herpesvirus pathogens in a smear from the surface of the pharyngeal tonsil. Results. In patients of the main group after the course of treatment (on the 30th day of follow-up), the severity of the "snoring" symptom was 67% lower (p = 0.001) relative to the comparison group, the intensity of the symptoms of "nasal breathing difficulty" and "cough" was 20% and 50% less, respectively. Also in the main group, there was a decrease in the proportion of patients with grade 3 adenoid hypertrophy (from 54% to 33%, p = 0.029) and grade 2 (from 15% to 4%, p = 0.046), accompanied by a block of the pharyngeal mouths of the auditory tubes (no such positive dynamics was noted in the comparison group). Among initially EBV-positive patients, the virus eradication was 78% in the main group, in the comparison group it did not exceed 12% (p = 0.015). Conclusion. The inclusion of the anti-inflammatory drug Reglisam in the treatment regimen of adenoiditis contributed to a more effective reduction in the severity of the symptoms of the disease ("nasal congestion", "cough", "snoring") and the restoration of nasal breathing, which was associated not only with the absence of signs of inflammation, but also with a decrease in the size of the pharyngeal tonsil. The antiviral effect of Reglisam against Epstein–Barr virus (EBV) turned out to be interesting from a practical point of view (in 78% of cases, there was no virus among initially EBV-positive patients). Key words: adenoiditis, Epstein–Barr virus, ammonium glycyrrhizinate, glycyrrhizic acid

THE USE OF STATINS FOR THE TREATMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND TYPE 2 DIABETES

Relevancy. The combination of chronic obstructive pulmonary disease and type 2 diabetes is studied insufficiently. The incomplete treatment regimen hinders the solution to this problem by including statins in the complex treatment of patients with chronic obstructive pulmonary disease combined with type 2 diabetes mellitus.
 Objective: to evaluate the effectiveness of including statins in the complex treatment of patients with chronic obstructive pulmonary disease secondary to type 2 diabetes mellitus.
 Materials and methods. Examination of patients with chronic obstructive pulmonary disease (COPD), including 64 patients with concomitant type 2 diabetes, was conducted on the basis of the pulmonology department of the Chernivtsi Regional Clinical Hospital in 2016-2020. Patients were divided into two groups – the main and the control. Patients with COPD with concomitant type 2 diabetes in the main group (49 patients) were prescribed atorvastatin at a dose of 20-40 mg once a day. The control group (15 COPD patients with concomitant type 2 diabetes) received essential treatment without atorvastatin. Patients received basic therapy depending on the group of patients (A, B, C and D) and the prevalence of shortness of breath or the frequency of exacerbations, long-acting bronchodilators (long-acting β2-agonists and/or long-acting anticholinergic drugs). A separate group of patients received a combination of a long-acting β2-agonist with an inhaled glucocorticosteroid. Some patients were prescribed roflumilast and antibactereal drugs from the group of macrolides (azithromycin or erythromycin). In the presence of sputum, patients were prescribed mucolytic drugs (Lazolvan, ACC, carbocisteine, erdosteine). In case of exacerbation, patients received a short course glucocorticosteroids parenterally, antibacterial drugs (for infectious exacerbation), nebulizer therapy. The effectiveness of therapy was evaluated after six months of treatment using the following diagnostic methods: clinical data (dyspnea, cough, sputum production - according to the BCSS scale; and shortness of breath, cough, sputum production and its color - according to the Paggiaro scale), the number of hospitalizations per year, the number emergency medical calls. Mathematical processing of the obtained data was carried out using programs BioStat 2009 Professional, version 5.8.4.3 (AnalystSoft Inc.), SPSS (Statistical Package for Social Science Statistics) 16.0, Statistisa 10.0 StatSoft Inc., Microsoft Excel 2010. Before testing statistical hypotheses were determined coefficients of asymmetry and kurtosis using the Hahn-Shapiro-Wilkie test to analyze the normality of the distribution of values ​​in randomized samples.
 Results. When analyzing clinical data in treatment dynamics with atorvastatin, it was found that according to the BCSS, shortness of breath in patients of the main group significantly decreased. Cough in COPD patients with concomitant type 2 diabetes treated with atorvastatin decreased by 25.3% at the end of treatment. A decrease in sputum production was observed in two groups of patients, and the changes were significant. Reduction of the frequency of exacerbations per year, the number of emergency calls, and the number of hospitalizations per year in the dynamics of atorvastatin treatment were also observed in COPD patients with concomitant type 2 diabetes.
 Conclusion. the use of atorvastatin in the complex treatment of COPD patients with concomitant type 2 diabetes resulted in a decrease in the frequency of exacerbations per year, the number of emergency calls, and the number of hospital admissions per year.

Natural cough remedies: options for a rational choice

This work summarizes the current understanding of the mechanisms providing mucociliary clearance and their disorders in respiratory diseases. It is noted that currently the understanding of the drainage function of the respiratory tract and cough formation in bronchopulmonary pathology has significantly expanded, and therefore much attention is paid to the search for opportunities to correct these parts of pathogenesis. The use of drugs improving sputum rheology and decreasing inflammatory mucosal edema are of great importance in this aspect. The article summarizes the data on the possibilities of pathogenetic correction of respiratory disorders with the emphasis on the use of expectorants and mucolytic drugs made from herbal raw materials. For many of them a sufficiently rich clinical experience has been accumulated, and modern manufacturing techniques have significantly increased their quality and safety. The mucolytic and expectorant properties of modern herbal remedies are in many cases as good as those of synthetic drugs. An important feature of herbal remedies is that they contain a combination of many components with a complex therapeutic effect, whereby the quality of herbal remedies is ensured by the most modern manufacturing control mechanisms. The paper reflects the main therapeutic effects of herbal remedies, which depend on the plant species and are determined by their content of biologically active substances: alkaloids, glycosides (including anthraglycosides, cardiac glycosides, saponins, flavonoids), phytoncides, essential oils, coumarins, tannins, resins, etc. The results of own observations on the use of herbal remedies in routine clinical practice are presented. The high adherence of patients to the use of herbal syrups and drops based on ivy extract in the therapy of cough syndrome in adults and children is shown.

Comparison of the antioxidant properties of serum and plasma samples as well as glutathione under environmental and pharmacological stress factors involving different classes of drugs

We compared the antioxidant activity of serum and plasma samples of a known glutathione content with the activity of glutathione, whilst determining to what extent various stress factors might change the activity of the tested samples. Copper ions and benzene were used as examples of environmental stress factors, and xenobiotics in the form of representatives of various groups of drugs, were used as examples of pharmacological stressors at therapeutic ranges. The activity was assessed by the ABTS, ORAC, FRAP and CUPRAC methods. Glutathione content was measured by the HPLC-FD method. During the experiments, plasma samples were shown to be more resistant to oxidative stress. Moreover, the important role of environmental xenobiotics in oxidative stress was revealed, as well as the differentiated influence of pharmaceutical xenobiotics. Among all pharmaceutical xenobiotics tested, including representatives of antiarrhythmic, antiepileptic, cytostatic and mucolytic drugs, the greatest stress was shown for antiarrhythmic drugs and cytostatics.

Modern Approaches in Management of Children with Cystic fibrosis

The problem of timely diagnosis and proper management of patients with cystic fibrosis is crucial not only in our country, but throughout the world. Experts of the Union of Pediatricians of Russia have considered various issues of etiology, pathogenesis, epidemiology, diagnosis, and treatment of this genetic disease in a modern light. Particular attention was paid to screening methods for early diagnosis of cystic fibrosis. The principles of complex therapy were justified, including rational use of antibacterial and mucolytic drugs and enzyme replacement therapy that significantly determine the disease prognosis.

The potential of erdosteine to reduce the rate of exacerbations of chronic obstructive pulmonary disease

Exacerbations of COPD worsen health status, increase the frequency of hospitalizations, the likelihood of disease progression, and the risk of adverse outcomes. One of the main goals of the treatment of stable COPD today is to reduce the frequency of exacerbations of the disease. Thus, the expansion of suitable therapeutic options is extremely relevant for clinical practice. Use of mucolytic drugs with antioxidant and anti-inflammatory effects in COPD is justified by the pathogenetic mechanisms. These drugs are able to reduce the frequency of exacerbations, among other positive effects.Aim. This article describes additional possibilities of pharmacotherapy using the mucoactive drug erdosteine as maintenance therapy for COPD aimed at preventing exacerbations of this disease.Conclusion. The use of erdosteine in patients with stable COPD helps reduce the frequency and duration of exacerbations of the disease, primarily in the patients with stage II according to GOLD.

Possible Treatment Approaches of Sulfur Mustard-Induced Lung Disorders, Experimental and Clinical Evidence, an Updated Review.

Sulfur mustard (SM) is one of the major potent chemical warfare that caused the death of victims in World War I and the Iraq-Iran conflict (1980–1988). The respiratory system is the main target of SM exposure and there are no definitive therapeutic modalities for SM-induced lung injury. The effects of the new pharmaceutical drugs on lung injury induced by SM exposure were summarized in this review. Literature review on PubMed, ScienceDirect, and Google Scholar databases was performed to find papers that reported new treatment approach on SM-exposure-induced injury in the respiratory system until October 2019. The search was restricted to sulfur mustard AND induced injury (in vitro studies, animal experiments, and clinical trials) AND respiratory system OR lung, AND treatment in all fields. Two hundred and eighty-three relevant articles were identified that 97 retrieved articles were eligible and were included in the review. Some new pharmaceutical drugs have shown therapeutic potential in controlling various characteristics of lung injury due to SM exposure. Recent studies showed therapeutic effects of mucolytic drugs, non-steroidal drugs, and antibiotics on reducing lung inflammation, oxidative stress responses, and modulating of the immune system as well as improving of respiratory symptoms and pulmonary function tests. Studies on the therapeutic effects of new agents with amelioration or treatment of SM-induced lung injury were reviewed and discussed.

Inhibitory mechanism of Ambroxol and Bromhexine Hydrochlorides as potent blockers of molecular interaction between SARS-CoV-2 spike protein and human angiotensin-converting Enzyme-2

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the host cells through interaction of its spike protein with human angiotensin-converting enzyme 2 (hACE-2). High binding affinity between the viral spike protein and host cells hACE-2 receptor has been reported to enhance the viral infection. Thus, the disruption of this molecular interaction will lead to reduction in viral infectivity. This study, therefore, aimed to analyze the inhibitory potentials of two mucolytic drugs; Ambroxol hydrochlorides (AMB) and Bromhexine hydrochlorides (BHH), to serve as potent blockers of these molecular interactions and alters the binding affinity/efficiency between the proteins employing computational techniques. The study examined the effects of binding of each drug at the receptor binding domain (RBD) of the spike protein and the exopeptidase site of hACE-2 on the binding affinity (ΔGbind) and molecular interactions between the two proteins. Binding affinity revealed that the binding of the two drugs at the RBD-ACE-2 site does not alter the binding affinity and molecular interaction between the proteins. However, the binding of AMB (−56.931 kcal/mol) and BHH (−46.354 kcal/mol) at the exopeptidase site of hACE-2, significantly reduced the binding affinities between the proteins compared to the unbound, ACE-2-RBD complex (−64.856 kcal/mol). The result further showed the two compounds have good affinity at the hACE-2 site, inferring they might be potent inhibitors of hACE-2. Residue interaction networks analysis further revealed the binding of the two drugs at the exopeptidase site of hACE-2 reduced the number of interacting amino residues, subsequently leading to loss of interactions between the two proteins, with BHH showing better reduction in the molecular interaction and binding affinity than AMB. The result of the structural analyses additionally, revealed that the binding of the drugs considerably influences the dynamic of the complexes when compared to the unbound complex. The findings from this study suggest the binding of the two drugs at the exopeptidase site reduces the binding effectiveness of the proteins than their binding at the RBD site, and consequently might inhibit viral attachment and entry.

Facile approaches for determination of Bromhexine Hydrochloride and its active metabolite Ambroxol Hydrochloride using Eosin Y

New validated Spectroscopic methods were developed to assay Bromhexine Hydrochloride and its active metabolite Ambroxol Hydrochloride separately in pure form and pharmaceutical formulations. The spectrophotometric assay (method I) shows complex formation between each of the drugs and Eosin Y at 540nm at pH 3.6 and 3.4mL of 4×10-4M Eosin for Bromhexine and Ambroxol. The Spectrofluorimetric assay (method II) depends on quenching eosin native fluorescence by the studied drugs, which measured at 540nm after excitation at 302nm. The spectrophotometric absorbance-concentration plot is rectilinear over the ranges (1.0-5.0) and (1.0-10.0) μg/mL for bromhexine and ambroxol with LOD of 0.31 and 0.14μg/mL and LOQ of 0.94 and 0.42μg/mL for the two drugs respectively. The fluorometric-concentration plot is linear along the range (1.0-5.0) μg/mL and (1-10) μg/mL for the two drugs respectively with LOD of 0.13μg/mL and 0.22μg/mL and LOQ of 0.4μg/mL and 0.65μg/mL for the two drugs, respectively. Developed assays have been validated in agreement with ICH recommendations and they were used in the analysis of commercial drug formulations containing the two mucolytic drugs and the results were matching with those obtained by the comparison method.

Challenge of surviving COPD with COVID-19 patient: review of the literature with unusual case report

Chronic obstructive pulmonary disease (COPD) refers to limitation of air flow and presence of persistent respiratory symptoms due to abnormalities in the airway or alveolar airway. COVID-19 patients with COPD have a higher mortality and morbidity. Recent studies revealed that present smokers have a higher risk mortality rate than the former and never smokers. However, COPD patients infected with SARS-CoV-2 have a low survival rate during the COVID-19 pandemic. Here we present a case of COVID-19 in a patient with COPD. The patient presented with shortness of breath, altered mental status, and loss of consciousness and 3 days prior was diagnosed with COVID-19, by reverse transcription polymerase chain reaction. The patient diagnosed by physical, and laboratory findings, and treated by giving 2 L/min oxygen on a ventilator pressure control ventilation mode, with administered antibiotic, antipyretic, proton pump inhibitors, and mucolytic drugs without complications. COVID-19 incidence is increased when there are other illnesses present, such as COPD. Based on 18 studies of 26,075 cases reporting, COPD was significantly associated with an increased risk of adverse outcomes in COVID-19 patients, particularly current smokers. We report a case of COVID-19, heavy smoker with a 1-year history of COPD with a positive outcome. The patient suffered from severe respiratory failure, requiring the use of ventilation gave 2 L/min oxygen on pressure control ventilation mode. Our findings suggest that the development of COVID-19, which could lead to death, needs critical assessment and special consideration for COPD patients and existing smokers.

Rational mucolytic therapy in respiratory diseases: clinical interpretation of pharmacological properties for informed choice

Respiratory diseases remain a common group of diseases in the practice of general physicians and pulmonologists. Currently, there are various treatment protocols for patients with respiratory diseases, where one of the pharmacological groups is mucolytic drugs. They affect the physical and chemical properties of sputum by splitting complex mucins, which leads to its liquefaction. Indications for use of drugs of this group are clinical conditions, in which there is a cough with thick, viscous, difficult to detach sputum. The article discusses the possibility of treating several respiratory diseases with mucolytic therapy, provides a comparative characteristic of drugs of this pharmacological group. The clinical and pharmacological effects of erdosteine are discussed in detail: mucolytic, antioxidant, anti-inflammatory, immunomodulatory. These properties of the drug are extremely important in clinical practice conditions, because in addition to the mucolytic properties themselves, the patient has many adverse processes due to inflammation. All this is associated with additional damaging factors regarding the tissues and may also indicate an increased risk of complications. Thus, the multipurpose effects of the mucolytic erdosteine in various respiratory tract diseases are presented. In addition to acute respiratory viral diseases, the clinical experience of using erdosteine in chronic obstructive pulmonary disease is discussed in detail. The most important indicator to assess the effectiveness of drugs used in this disease is the reduction in the number of exacerbations per year and the severity of the course of the exacerbation. The conclusions, which are given according to the results of a number of studies, determine significant advantages in the use of erdosteine as mucolytic therapy.

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Антибиопленочные эффекты муколитических лекарственных средств

Муколитические лекарственные средства обладают способностью нарушать структуру матрикса и разрушать сформированные бактериальные биопленки. Наиболее изученным является N-ацетилцистеин. Впервые антибиопленочная активность N-ацетилцистеина была продемонстрирована Ciro Pérez-Giraldo и соавт. в 1997 году. Они показали, что вещество оказывает ингибирующее действие на рост бактерий и способствует диспергированию биопленок, образованных бактериями Staphylococcus epidermidis. В настоящее время установлено, что N-ацетилцистеин обладает выраженной активностью, направленной против биопленок, сформированных различными грамположительными и грамотрицательными бактериями, в том числе и антибиотикорезистентными бактериальными штаммами метициллинрезистентного золотистого стафилококка и хинолонрезистентных синегнойных палочек. N-ацетилцистеин способствует проникновению пенициллинов, полимиксинов, фторхинолонов в самые глубокие слои биопленки, преодолевая антибио­тикорезистентность причинно-значимых бактериальных агентов. N-ацетилцистеин может применяться как антибиопленочное лекарственное средство при хронических бактериально-ассоциированных заболеваниях, в частности при эпизодах респираторных инфекций у больных муковисцидозом, хроническом бронхите, хронической обструктивной болезни легких. Полагают, что N-ацетилцистеин обладает превосходным профилем безопасности и эффективности при лечении заболеваний, которые сопровождаются образованием бактериальных биопленок. N-ацетилцистеин и нанотехнологические лекарственные средства, в которых его молекулы скомбинированы с частицами галлия или серебра, могут стать средствами выбора, диспергирующими биопленки и усиливающими эффективность антибактериальной терапии, особенно при заболеваниях, вызванных антибиотикорезистентными штаммами микроорганизмов.

Serratiopeptidase, A Serine Protease Anti-Inflammatory, Fibrinolytic, and Mucolytic Drug, Can Be a Useful Adjuvant for Management in COVID-19.

Serratiopeptidase, A Serine Protease Anti-Inflammatory, Fibrinolytic, and Mucolytic Drug, Can Be a Useful Adjuvant for Management in COVID-19.

Особливості призначення муколітичної терапії у дітей у постнападному періоді бронхіальної астми

Bronchial asthma is the most common chronic pathology in childhood. Chronic inflammatory process of the respiratory tract forms bronchial hyperreactivity which is manifested by typical clinical symptoms. Like any other chronic disorder, the course of bronchial asthma consists of periods of exacerbation and remission. A productive cough in the post-attack period determines the prescription of mucolytic drugs by doctors to liquefy viscous sputum, to remove it more quickly, especially among the paediatric population. There are different approaches to prescribing mucolytic drugs during exacerbation of symptoms of bronchial asthma in scientific publications. The purpose of the study was to evaluate the clinical effectiveness of mucolytic therapy in children with bronchial asthma to optimize the treatment of disease exacerbations. Material and methods. One hundred two medical records of patients treated for asthma exacerbation in pulmonological department of the Chernivtsi Regional Children Clinical Hospital were analyzed. Four clinical groups were formed depending on the prescription of mucolytic drugs. There were not any significant differences by sex, place of residence, however the average age of patients who were prescribed carbocisteine. It was significantly less than in children of other clinical groups. Results and discussion. It was determined that acetylcysteine and carbocysteine were prescribed to patients on the first day of the productive cough onset. Instead to children of the IV clinical group where ambroxol was prescribed on average 1.6 days before the wet cough onset. The study results showed that the average duration of hospitalization in patients receiving ambroxol was 1.5 days less than in children taking acetylcysteine or carbocysteine. The difference was significant. However, the duration of hospitalization for children of I clinical group was not significant longer in comparison with patients received drugs with mucolytic effect in the complex therapy of asthma exacerbation. Conclusion. Despite the fact that acetylcysteine and carbocysteine were significantly more often prescribed for more severe and pronounced asthma exacerbation a decrease in the relative and absolute risks of longer hospitalization was observed in patients taking carbocysteine