Mucoactive agent

Mucoactive agents are a class of pharmacologic agents that include expectorants, mucolytics, mucoregulators, and mucokinetics that can affect the volume, viscosity, transportation, and composition of mucus or sputum.^[1][2][3] They often aid in clearing mucus or sputum from the upper and lower airways. These medications are used to treat respiratory diseases complicated by the oversecretion or inspissation of mucus. These drugs can be further categorized by their mechanism of action.^[4][5]

Mucoactive agents—expectorants—include mucolytics, secretolytics and mucokinetics (also called secretomotorics) ^[6]

• Mucolytics: thin (reduce the viscosity of) mucus^[5]
• Secretolytics: increase airway water or the volume of airway secretions ^[5]
• Mucokinetics: increase mucociliary transport (clearance) and transportability of mucus by cough ^[5]
• Mucoregulators: suppress underlying mechanisms of mucus hypersecretion^[5]

Alternatively, attacking the affinity between secretions and the biological surfaces is another avenue, which is used by abhesives and surfactants.

Any of these effects could improve airway clearance during coughing.

In general, clearance ability is hampered by the bonding to surfaces (stickiness) and by the viscosity of mucous secretions in the lungs. In turn, the viscosity is dependent upon the concentration of mucoprotein in the secretions.

Mucolytics, secretolytics and secretomotorics are different types of medication, yet they are intended to promote drainage of mucus from the lungs.

An expectorant (from the Latin expectorare, to expel or banish) works by signaling the body to increase the amount or hydration of secretions, resulting in more, yet clearer, secretions and lubricating the irritated respiratory tract.^[7] One mucoactive agent, guaifenesin, has anxiolytic and muscle-relaxing properties. It is commonly available in cough syrups and also as sustained-release tablets.

Los mucolíticos pueden disolver la mucosidad espesa y se utilizan habitualmente para aliviar las dificultades respiratorias. Lo hacen rompiendo los enlaces químicos entre las moléculas de la mucosidad. ^{[ 8 ]} Esto, a su vez, puede disminuir la viscosidad al alterar los componentes que contienen mucina .

Los expectorantes aumentan las secreciones bronquiales y los mucolíticos ayudan a fluidificar las secreciones bronquiales espesas. Los expectorantes reducen la viscosidad de las secreciones bronquiales, aumentando así el flujo de moco que se elimina más fácilmente al toser. Los mucolíticos descomponen la estructura química de las moléculas de moco. El moco se vuelve más fluido y se elimina más fácilmente al toser.

• Tioles
  • acetilcisteína
  • mesna
  • fexlamosa (en investigación) ^{[ 9 ] [ 10 ]}
• tioésteres
  • carbocisteína
  • erdosteína
  • mecisteína
• Similar a la bromhexina
  • ambroxol
  • bromhexina
• ADNasa
  • dornasa alfa
• secretolíticos irritantes
  • cloruro de amonio (la FDA no cree que funcione) ^{[ 11 ]}
• Citratos
  • citrato de potasio
  • citrato de sodio (la FDA no cree que funcione) ^{[ 11 ]}
• yoduros
  • yoduro de potasio
• Compuestos o extractos derivados de plantas
  • guaifenesina (no funciona en infecciones de las vías respiratorias superiores) ^{[ 12 ] [ 13 ]}
  • hidrato de terpina (la FDA no cree que funcione) ^{[ 11 ]}
  • bálsamo de tolú (la FDA no cree que funcione) ^{[ 11 ]}
  • Extractos de Justicia adhatoda

• Adams, Michael; Holland, Leland Norman; Bostwick, Paula Manuel (2016). Farmacología para enfermeras: Un enfoque fisiopatológico (5.ª  ed.). Pearson Education. pág.  960. ISBN 978-0134255163.

• Rubin, Bruce K (1 de julio de 2007). "Mucolíticos, expectorantes y medicamentos mucocinéticos" . Respiratory Care . 52 (7): 859– 865. PMID 17594730 . 

• Centro Nacional de Información Biotecnológica