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A cough is a sudden expulsion of air through the large breathing passages which can help clear them of fluids, irritants, foreign particles and microbes. As a protective reflex, coughing can be repetitive with the cough reflex following three phases: an inhalation, a forced exhalation against a closed glottis, and a violent release of air from the lungs following opening of the glottis, usually accompanied by a distinctive sound.
Cold medicines are a group of medications taken individually or in combination as a treatment for the symptoms of the common cold and similar conditions of the upper respiratory tract. The term encompasses a broad array of drugs, including analgesics, antihistamines and decongestants, among many others. It also includes drugs which are marketed as cough suppressants or antitussives, but their effectiveness in reducing cough symptoms is unclear or minimal.
The respiratory tract is the subdivision of the respiratory system involved with the process of respiration in mammals. The respiratory tract is lined with respiratory epithelium as respiratory mucosa.
Mucus is a slippery aqueous secretion produced by, and covering, mucous membranes. It is typically produced from cells found in mucous glands, although it may also originate from mixed glands, which contain both serous and mucous cells. It is a viscous colloid containing inorganic salts, antimicrobial enzymes, immunoglobulins, and glycoproteins such as lactoferrin and mucins, which are produced by goblet cells in the mucous membranes and submucosal glands. Mucus serves to protect epithelial cells in the linings of the respiratory, digestive, and urogenital systems, and structures in the visual and auditory systems from pathogenic fungi, bacteria and viruses. Most of the mucus in the body is produced in the gastrointestinal tract.
Ipratropium bromide, sold under the trade name Atrovent among others, is a type of anticholinergic medication which opens up the medium and large airways in the lungs. It is used to treat the symptoms of chronic obstructive pulmonary disease and asthma. It is used by inhaler or nebulizer. Onset of action is typically within 15 to 30 minutes and lasts for three to five hours.
Guaifenesin, also known as glyceryl guaiacolate, is an expectorant medication taken by mouth thought to aid in the elimination of sputum from the respiratory tract. Chemically it is an ether of guaiacol and glycerine. It is often used in combination with other medications. A 2014 study found that guaifenesin did not have significant impact on sputum production or clearance in upper respiratory infections.
Post-nasal drip (PND), also known as upper airway cough syndrome (UACS), occurs when excessive mucus is produced by the nasal mucosa. The excess mucus accumulates in the back of the nose, and eventually in the throat once it drips down the back of the throat. It can be caused by rhinitis, sinusitis, gastroesophageal reflux disease (GERD), or by a disorder of swallowing. Other causes can be allergy, cold, flu, and side effects from medications.
Goblet cells are simple columnar epithelial cells that secrete gel-forming mucins, like mucin 5AC. The goblet cells mainly use the merocrine method of secretion, secreting vesicles into a duct, but may use apocrine methods, budding off their secretions, when under stress. The term goblet refers to the cell's goblet-like shape. The apical portion is shaped like a cup, as it is distended by abundant mucus laden granules; its basal portion lacks these granules and is shaped like a stem.
Bromhexine is a mucolytic drug used in the treatment of respiratory disorders associated with viscid or excessive mucus. It was developed in the research laboratory of Boehringer Ingelheim in the late 1950s as an active ingredient for pharmaceutical use, patented in 1961, introduced in 1963 under the trademark of Bisolvon® and came into medical use in 1966.
Ambroxol is a drug that breaks up phlegm, used in the treatment of respiratory diseases associated with viscid or excessive mucus. Ambroxol is often administered as an active ingredient in cough syrup.
Pentoxyverine (rINN) or carbetapentane is an antitussive commonly used for cough associated with illnesses like common cold. It is sold over-the-counter as Solotuss, or in combination with other medications, especially decongestants. One such product is Certuss, a combination of guaifenesin and pentoxyverine.
A mucoprotein is a glycoprotein composed primarily of mucopolysaccharides. Mucoproteins can be found throughout the body, including the gastrointestinal tract, reproductive organs, airways, and the synovial fluid of the knees. They are called mucoproteins because the carbohydrate quantity is more than 4% unlike glycoproteins where the carbohydrate quantity is less than 4%. Mucoprotein is produced in the cecum of the gastrointestinal tract. During gallbladder cancer, mucoprotein is over expressed. Sustaining a brain injury will lead to decreased mucoprotein production. The result is an alteration of gut microbiota as seen in mice.
Erdosteine is a molecule with mucolytic activity. Structurally it is a thiol derivative characterized by the presence of two thiol groups. These two functional sulfhydryl groups contained in the molecule are released following first-pass metabolism with the conversion of erdosteine into its pharmacologically active metabolite Met-I.
Bronchitis is inflammation of the bronchi in the lungs that causes coughing. Bronchitis usually begins as an infection in the nose, ears, throat, or sinuses. The infection then makes its way down to the bronchi. Symptoms include coughing up sputum, wheezing, shortness of breath, and chest pain. Bronchitis can be acute or chronic.
Pulmonary hygiene, formerly referred to as pulmonary toilet, is a set of methods used to clear mucus and secretions from the airways. The word pulmonary refers to the lungs. The word toilet, related to the French toilette, refers to body care and hygiene; this root is used in words such as toiletry that also relate to cleansing.
Terpin, used as the hydrate (terpin·H2O), is an expectorant, used to loosen mucus in patients with bronchitis and related conditions. It is derived from sources such as turpentine, oregano, thyme, and eucalyptus. It was used in the United States in the late nineteenth century, but was removed from marketed medications in the 1990s after the Food and Drug Administration (FDA) found a lack of evidence of safety and effectiveness. Elixirs of terpin hydrate are still available with a prescription, but must be prepared by a compounding pharmacy.
Guaifenesin/phenylephrine is a combination of the drugs guaifenesin and phenylephrine and is a preparation against the symptoms of cold, flu and allergy. Guaifenesine is an expectorant, phenylephrine is a decongestant. The drug is sold under the brand name Entex and as generic brands. Entex La is 400 mg guaifenesin and 30 mg phenylephrine hydrochloride. Entex Pse is 600 mg guaifenesin and 120 mg phenylephrine hydrochloride. Both are extended release products, meaning that the non-active ingredients are chosen to dissolve slowly to provide a prolonged therapeutic effect.
Plastic bronchitis (PB) is a disorder in which branching casts of the airways are expectorated. PB is not a single disease with a defined mechanism that explains the cast formation in all conditions. Examples of diseases associated with expectoration of casts, and which sometimes are labeled PB include tuberculosis, atypical mycobacterial disease, allergic bronchopulmonary aspergillosis, and asthma.
Chronic cough is long-term coughing, sometimes defined as more than several weeks or months. The term can be used to describe the different causes related to coughing, the three main ones being upper airway cough syndrome, asthma and gastroesophageal reflux disease. It occurs in the upper airway of the respiratory system. Generally, a cough lasts around one to two weeks; however, chronic cough can persist for an extended period of time defined as six weeks or longer. People with chronic cough often experience more than one cause present. Due to the nature of the syndrome, the treatments used are similar; however, there are a subsequent number of treatments available, and the clinical management of the patients remains a challenge.
Airway clearance therapy is treatment that uses a number of airway clearance techniques to clear the respiratory airways of mucus and other secretions. Several respiratory diseases cause the normal mucociliary clearance mechanism to become impaired resulting in a build-up of mucus which obstructs breathing, and also affects the cough reflex. Mucus build-up can also cause infection, and inflammation, and repeated infections can result in damage to the airways, and the lung tissue.
References
- ↑ Balsamo, R.; Lanata, L.; Egan, C. G. (2010). "Mucoactive drugs". European Respiratory Review. 19 (116): 127–33. doi: 10.1183/09059180.00003510 . PMID 20956181.
- 1 2 3 4 5 Rogers, D. F. (2007). "Mucoactive agents for airway mucus hypersecretory diseases". Respiratory Care. 52 (9): 1176–93, discussion 1193–7. PMID 17716385.
- ↑ Rubin, Bruce K. (2006). "The pharmacologic approach to airway clearance: Mucoactive agents". Paediatric Respiratory Reviews. 7 (Supplement 1): S215–S219. doi:10.1016/j.prrv.2006.04.198. PMID 16798570.
- ↑ "Definition of Expectorant". MedicineNet. 13 May 2016. Retrieved 4 January 2018.
- 1 2 "NCATS Inxight: Drugs – MECYSTEINE HYDROCHLORIDE". drugs.ncats.io. Retrieved 29 May 2019.
- Adams, Michael; Holland, Leland Norman; Bostwick, Paula Manuel (2016). Pharmacology for Nurses: A Pathophysiologic Approach (5 ed.). Pearson Education. p. 960. ISBN 978-0134255163.
- Rubin, Bruce K (1 July 2007). "Mucolytics, Expectorants, and Mucokinetic Medications". Respiratory Care. 52 (7).
