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Means that promote the removal of sputum from the pulmonary tract, play
important role in the treatment of various bronchopulmonary diseases'.
For a long time, the main drugs used for this purpose
there were expectorants, the effect of which is largely related
with stimulation of receptors of mucous membranes of the bronchial passages and mecha-
increased sputum promotion.
Recently, new opportunities for improving the "drainage"
bronchial function using pharmacological agents. A number of new
drugs allows you to change the rheological properties of
Moles and its adhesive indicators, as well as facilitate the excretion of sputum
physiological way.
Currently, drugs used to remove sputum, divide
into 2 main groups:
- stimulating expectoration (secretomotor);
- mucolytic (bronchosecretolitic).
Secret motor preparations enhance the physiological activity of
peritaltic movements of the bronchioles, contributing to
sputum movement from the lower divisions to the upper respiratory tract and
its removal. This effect is usually combined with increased secretion of bronchial
chial glands and some decrease in sputum viscosity. Conventionally, the
The rats of this group are divided into 2 subgroups: reflex and resorptive
Reflex action preparations (preparations of thermopsis, istoda, althea
and other medicinal plants, sodium benzoate, terpinehydrate, etc.) with
ingestion have a moderate irritant effect on the receptors of
gastric zona and reflex effect on the bronchi and bronchial
glands. The effect of some drugs is also associated with stimulating
exposure to vomiting and respiratory centers (thermopsis, etc.).
The means of reflex action also include drugs with predominantly
giving vomiting activity (apomorphine, licorin), providing in small
doses of expectorant effect. A number of drugs reflex action of
It also has a resorptive effect: the essential substances contained in them
oils and other substances are released through the respiratory tract and cause
increased secretion and sputum thinning.
Resorptive preparations (sodium and potassium iodide, ammonium chloro-
Reed, partially - sodium bicarbonate, etc.) have the effect mainly
when they are expelled (after ingestion) by the mucous membrane of the respiratory
tey, stimulate the bronchial glands and cause direct dilution
sputum rehydration; to a certain extent they also stimulate
motor function of ciliated epithelium and bronchioles. Especially active
affect the viscosity of sputum iodine preparations.
To stimulate expectoration in bronchopulmonary diseases
not only medicinal plants in the form of decoctions, but also
stand, mixtures, "chest collections", etc., but also some selected from
plants individual substances.
As mucolytic (secretolytic) agents, first used
some enzyme (proteolytic) preparations (trypsin, ribon-
kleazu, deoxyribonucliase, etc.), and recently began to find
the use of specifically acting synthetic drugs (acetylcysteine,
Bromhexine, Ambroxol, etc.).
Mucolytic drugs differ in their mechanism of action. Proteo
Lytic enzymes break peptide bonds of a protein molecule. Ribono
Clease causes the depolymerization of RNA. Acetylcysteine ​​promotes rupture
disulfide bonds of acid mucopolysaccharides of the sputum gel.
It is now proven that the action of bromhexine and close to
him on the structure of the new drug Ambroxol (Lasolvana) and some of them
analogs due to their specific ability to stimulate the production of
endogenous surfactant (from the word "surface" - the surface), surface
active substances of lipid-protein-mucopolysaccharide nature, synthesis
driven in alveolar cells. Pulmonary surfactant (antiatelectasis
factor) lines in the form of a thin film the inner surface of the lungs; he
ensures the stability of alveolar cells during respiration, protects
them from adverse factors, contributes to the regulation of rheological
properties of bronchopulmonary secretions, improving its "slip" on the epithelium
and facilitate sputum secretion from the respiratory tract.
Violation of the biosynthesis of surfactant is observed in various broncho-
fatal diseases, and the use of surfactant stimulants
is regarded as one of the important pathogenetic links of the pharmacotherapeutic
these diseases.
It has also been established that lung surfactant deficiency is observed
with respiratory distress syndrome (respiratory distress syndrome) in
Recently, in medical practice began to apply not only
stimulants of surfactant biosynthesis, but also artificial surface-active
substances that replace natural surfactant in violation of its formation
due to diseases of the lungs or exposure to damaging
factors (see alveofakt).
All expectorant drugs are usually prescribed in complex therapy.
If necessary, they are given along with bronchodilators, antibacterial
drugs, heart means'.
To improve liquefaction and sputum separation, it is recommended when
To change expectorants, especially secretomotor drugs, to prescribe
plentiful warm drink.

Subgroup Expectorants include subgroups: