Mucolytic Flashcards
what is a mucolytic drug
–they thin out secretions by breaking down the structure of the mucus
–they alter the consistency of the gel layer
Factors that slow down mucociliary transport rate
–COPD
–Airway dryness
–Narcotics
–Endotracheal suctioning
–cigarette smoke
–hyperoxia
Mucoactive agent
–any agent that has an effect on mucus secretions including expectorant and mucolytics
Mucokinetic agent
–drugs that increase cough or ciliary clearance of secretions
–Bronchodilators: increase expiratory airflow
–Surfactants: prevent airway drying/dehydration
-Has shown to be effective in treating chronic brinchitis and CF
Mucoregulatory agent
–drugs that reduce the volume of airway secretions
–Decrease mucus hypersecretions
–Drugs used: Steriods
-Anticholinergics
-Atropine
-Ipratropium Bromide
-Tritropium
-Macrolide antibiotics
Mucolytic agent
–drugs that breaks down the structure of mucus
Expectorant
–drug that increases the secretion of sputum by airway passages when a patient is dry
–Pt is unable to produce secretions
When is Mycolytic drugs used
–Cystic Fibrosis
–Chronic Bronchitis
–Pneumonia
–Asthma
–Bronchiectasis
–Therapy to decrease infection/edema
–Removal of irritants
–tobacco smoking
Mycolytic: n-Acetyle-L-cysteine (NAC)
Trade Name: Mucomyst
–Smelly odor, rotten egg
–Does not combine with any drug
–Mode of Action: breaks down the structure of mucus
-makes mucus thinner
–Method of Admin: 10% and 20% mucomyst
-SNV: 3-5mL
–Hazards: Bronchospasm, mechanical obstruction, stomatitis, nausea, vomiting, rhinorrhea
–Try to give Albuterol first
Mucolytic: Dornase Alfa
–Trade Name: Pulmozyme
–Treatment of CF
–It is an Orphan Drug
–Mode of Action: when given by aerosol, it reduces viscosity and adhesivity of infection secretions by breaking down DNA
–Method of Admin: single use ampule 2.5mg in 2.5mL of clear, colorless solution
-Hudson RCI UP-Draft II OPTI-neb
-Acron II nebulizer
-PARI LC PLUS nebulizer
–Should be refrigerated and protected from light
–Side Effects:
-voice alterations, pharyngitis, rash, chest pain, conjunctivities
Expectorants: Sodium Bicarbonate
–inflammation caused by bicarbonate is thought to draw water into secretions
–has not be clinically demonstrated to improve airway mucus clearance
–cannot recommend its use
–Method of Admin: aerosol or direct tracheal irrigation
–Trade Name: Guaifenesin
–Brand Name: Mucinex, Robitussin
Mucactive agents: Hypertonic Saline
–Indications for use: may increase FEV1 in patients
The alternate effect is an acute decrease in FEV1
-irritant to induce cough to obtain specimens for diagnosis
–Mode of Action: promotes mucus clearance
–Method of Admin: SVN: 4mL
–used to diluent if patient has salt restrictions
–Agents: Hypertonic Saline 7%
Hypertonic Saline 3%
Hyperosmolar and dry powder mannitol (Bronchiltol and Aridol)
–Cautions: unpleasant taste, coughing may make it unsuitable for long-term
Mucoactive Therapies: Gravity
–not primary mechanism for normal mucociliary transport
–may show benefits when used with chest physiotherapy (CPT)
Mucoactive Therapies: Insufflation-Exsufflation (cough assist)
–inflates lungs with positive pressure followed by negative pressure to simulate cough
–primary application in patient with neurologic muscular weakness
Mucoactive Therapy: Active Cycle of Breathing (ACB) and Forced Expiratory technique (FET)
–breathing control
–thoracic expansion control
–forced expiration technique from progressively increasing lung volume
