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Drugs that help remove sputum from the pulmonary tract play
an important role in the treatment of various bronchopulmonary diseases. '
For a long time, the main drugs used for this purpose,
there were expectorants, the effects of which are largely associated
with stimulation of receptors of the mucous membranes of the bronchial tracts and fur
sputum promotion.
Recently, new opportunities to improve the "drainage"
function of the bronchial pathways with the help of pharmacological agents. A number of new
drugs allows you to change the rheological properties of mo-
moles and its adhesive characteristics, as well as facilitate the elimination of sputum
physiological way.
Currently, drugs used to remove sputum are divided
into 2 main groups:
- stimulating expectoration (secretory);
- mucolytic (bronchosecretolytic).
Secretomotor drugs enhance the physiological activity of Merz
epithelium and peristaltic movements of the bronchioles, contributing to
the movement of sputum from the lower sections to the upper respiratory tract and
its withdrawal. This effect is usually combined with increased secretion of bron-
chial glands and some decrease in sputum viscosity. Conditionally prep
the doses of this group are divided into 2 subgroups: reflex and resorptive
Drugs of reflex action (preparations of thermopsis, isoda, marshmallow
and other medicinal plants, sodium benzoate, terpinghydrate, etc.) with
ingestion have a moderate irritant effect on receptors
gastric mucosa and reflexively affect the bronchi and bronchial
glands. The effect of some drugs is also associated with a stimulating effect.
exposure to the vomiting and respiratory centers (thermopsis, etc.).
Reflexive agents also include drugs with a predominantly
giving emetic activity (apomorphine, lycorin), providing in small
doses expectorant effect. A number of drugs of reflex action
also has a resorptive effect: the ester contained in them
oils and other substances are released through the respiratory tract and cause
increased secretion and liquefaction of sputum.
Resorptive drugs (sodium and potassium iodide, ammonium chloro-
reed, partially sodium bicarbonate, etc.) have an effect mainly
when they are secreted (after ingestion) by the mucous membrane of the respiratory tract
They stimulate the bronchial glands and cause immediate inflammation.
burning (rehydration) of sputum; to a certain extent they also stimulate
motor function of ciliated epithelium and bronchioles. Especially active
iodine preparations affect the viscosity of sputum.
To stimulate expectoration in bronchopulmonary diseases since ancient times
widely used are not only medicinal plants in the form of decoctions,
stoya, potions, "breast fees", etc., but also some isolated from
plants individual substances.
As mucolytic (secretolytic) drugs, first
shed some enzyme (proteolytic) drugs (trypsin, ribo-
klease, deoxyribonuclease, etc.), and recently they began to find
the use of specific synthetic drugs (acetylcysteine,
Bromhexine, Ambroxol, etc.).
Mucolytic drugs differ in the mechanism of action. Proteo
lytic enzymes break peptide bonds of a protein molecule. Ribon-
klease causes depolymerization of RNA. Acetylcysteine ​​promotes rupture
disulfide bonds of acid mucopolysaccharides of sputum gel.
It has now been proven that the action of bromhexine and close to
the structure of the new drug ambroxol (lasolvan) and some of them
analogues due to their specific ability to stimulate production
endogenous surfactant (from the word "surface" - surface), surface-
of the active substance of lipid-protein-mucopolysaccharide nature, synthesis
alveolar cells. Pulmonary surfactant (antiatelectase
factor) lines the inner surface of the lungs in the form of a thin film; he
provides stability of alveolar cells during respiration, protects
them from adverse factors, contributes to the regulation of rheological
properties of bronchopulmonary secretion, improving its "sliding" along the epithelium
and facilitate the release of sputum from the respiratory tract.
Violation of the biosynthesis of surfactant is observed with various bronchial
diseases, and the use of surfactant stimulants
regarded as one of the important pathogenetic links of the pharmacothera -
FDI of these diseases.
It has also been found that lung surfactant deficiency is observed.
with respiratory distress syndrome (respiratory distress syndrome)
Recently, in medical practice, they began to use not only
surfactant biosynthesis stimulants, but also artificial surface-active
substances that replace natural surfactant in violation of its image
in connection with lung diseases or exposure to damaging
factors (see Alveofact).
All expectorant drugs are usually prescribed in combination therapy.
If necessary, they are given together with bronchodilators, antibacterial
drugs, cardiac drugs. '
To improve liquefaction and separation of sputum is recommended when
change in expectorant, especially secretory, drugs
plentiful warm drink.

Subgroup Expectorants includes subgroups: