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Expectorants

Means that promote the removal of sputum from the pulmonary ways, play
An important role in the treatment of various bronchopulmonary diseases. "
For a long time, the main drugs used for this purpose,
Were expectorants, the effect of which is significantly related
With stimulation of receptors of mucous membranes of bronchial ways and mecha-
Increased sputum.
Recently, new opportunities appeared to improve the "drainage"
Functions of bronchial tracts with the help of pharmacological agents. A number of new
Drugs allows you to change the rheological properties of the
Moles and its adhesive indices, as well as to facilitate the excretion of phlegm
Physiologically.
Currently, drugs used to remove phlegm, divide
On 2 main groups:
- stimulating expectoration (secretory);
- mucolytic (bronchosecretolitic).
Secretory drugs enhance the physiological activity of Mica-
Epithelium and peristaltic movements of bronchioles, contributing to the
Sputum from the lower parts to the upper respiratory tract and
Its derivation. This effect is usually combined with increased secretion of bronchial asthma
Chial glands and some decrease in the viscosity of sputum. Conditionally prepa-
The groups of this group are divided into 2 subgroups: reflex and resorptive de-
Tion.
Preparations of reflex action (preparations of thermopsis, rundown, althea
And other medicinal plants, sodium benzoate, terpinhydrate, etc.) at
Ingestion have a moderate irritant effect on the receptors of the
Zistoy shell of the stomach and reflex influence on the bronchi and bronchial
Glands. The effect of some drugs is also associated with a stimulating
Exposure to the emetic and respiratory centers (thermopsis, etc.).
Means of reflex action also include preparations with a predominantly
Giving emetic activity (apomorphine, lycorin), rendering in small
Doses of expectorant effect. A number of preparations of reflex action hour-
It also has a resorptive effect: the ethereal
Oils and other substances are released through the respiratory tract and cause
Increased secretion and dilution of sputum.
Preparations of resorptive action (iodide sodium and potassium, ammonium chloro-
Rid, partially - sodium bicarbonate, etc.) have an effect in the main
When they are isolated (after ingestion) by the mucous membrane of respiratory tracts
Stimulate the bronchial glands and cause a direct
Sputum (rehydration); To some extent they also stimulate
Motor function of the ciliated epithelium and bronchioles. Particularly active
Iodine preparations affect the viscosity of phlegm.
To stimulate the expectoration of bronchopulmonary diseases for a long time
Widely used not only medicinal plants in the form of broths,
Stoi, potions, "nursing fees", etc., but also some of the
Individual substances.
As mucolytic (secretolithic) agents,
Some enzyme (proteolytic) drugs (trypsin, ribonu-
Glaucoma, deoxyribonuclease, etc.), and recently they began to find
The use of specifically acting synthetic drugs (acetylcysteine,
Bromhexine, ambroxol, etc.).
Mucolytic drugs differ in the mechanism of action. Proteo-
Lytic enzymes break the peptide bonds of the protein molecule. Ribon-
The cleavage causes depolymerization of RNA. Acetylcysteine ​​promotes rupture
Disulfide bonds of acid mucopolysaccharides of sputum gel.
At present, it has been proved that the action of bromhexine and
It is based on the structure of a new drug ambroxol (lasolvan) and some of them
Analogues is due to their specific ability to stimulate production
Endogenous surfactant (from the word "surface" - surface), surface
But-active substance lipid-protein-mucopolysaccharide nature,
Alveolar cells. Pulmonary surfactant (anti-teleclactus
Factor) lining the inner surface of the lungs as a thin film; he
Ensures the stability of alveolar cells in the process of breathing, protects
Them from adverse factors, contributes to the regulation of rheological
Properties of bronchopulmonary secretion, improvement of its "slip" along the epithelium
And facilitate the release of sputum from the respiratory tract.
Disruption of the biosynthesis of surfactant is observed with various broncho-
And the use of stimulants for the formation of surfactant
Is regarded as one of the important pathogenetic links of the pharmacotherapeutic-
Pi of these diseases.
It was also established that insufficiency of the lung surfactant was observed
In the syndrome of respiratory distress (respiratory distress syndrome) in
Newborns.
Recently, in medical practice, not only
Stimulators of the biosynthesis of surfactant, but also artificial surface-active-
Substances that replace natural surfactant in violation of its formation
In connection with lung diseases or exposure to damaging
Factors (see Alveofakt).
All expectorants are usually prescribed in complex therapy.
If necessary, they are given together with bronchodilators, antibacterial
Drugs, cardiac drugs'.
To improve the dilution and separation of sputum, it is recommended that
Modifying expectorants, especially secretory-motor drugs, prescribing
Abundant warm drink.