Conditions affecting sputum viscosity

Question 1

Mucolytics

Answer 1

(Acetylcysteine, Carbocisteine, Erdosteine)
• Side effects: GI haemorrhage, skin reactions, Stevens-Johnson syndrome, vomiting
• Avoid in pregnancy

Question 2

Cystic fibrosis

Answer 2

Cystic fibrosis is a genetic disorder affecting the lungs, pancreas, liver, intestine, and reproductive organs.

• The main clinical signs are pulmonary disease, with recurrent infections and the production of copious viscous sputum, and malabsorption due to pancreatic insufficiency. Other complications include hepatobiliary disease, osteoporosis, cystic fibrosis-related diabetes, and distal intestinal obstruction syndrome.

Question 3

Cystic fibrosis treatment:

Answer 3

Dornase alfa is the first choice mucolytic. If there is an inadequate response, add hypertonic sodium chloride or use mannitol dry powder for inhalation

Question 4

If liver function blood tests are abnormal in patients with cystic fibrosis

Answer 4

ursodeoxycholic acid [unlicensed indication] can be given until liver function is restored.

Question 5

Mucolytics CI

Answer 5

Active peptic ulcers (Mucolytics disrupt gastric mucosa)

Question 6

Medical emergency: Croup

Answer 6

Dexamethasone oral solution

Child 1 month to 2 years