Mucus-Controlling Drug Therapy Flashcards
KT: abhesive
substance that redcues adhesion
KT: expectorant
medication meant to increase the volume or hydration o airway secretion
KT: mucin
the principal constituent of mucus and a high-molecular-weight glycoprotein, it gives mucus its physical/chemical properties such as viscoelasticity
KT: mucoactive agent
term connoting any medication or drug that has an effect on mucus secretion: may include mucolytic, expectorant, mucospissic, mucoregulatory, or mucokinetic agents
KT: mucokinetic agent
medication that increases cough or ciliary clearance of respiratory secretions
KT: mucolytic agent
medication that degrades polymers in secretions
KT: mucoregulatory agent
drug that reduces the volume of airway mucus secretion
KT: mucospissic agent
medication that increases viscocity of secretions and may be effective in the therapy of bronchorrhea
N-Acetylcysteine (NAC)
- Mucolytic, Mucoactive
- MucoMyst (10%, 20%)
- Breaks disulfide bonds
- Used for viscous secretions (plugs) or acetaminophen overdose
Dornase alfa
- Mucolytic, Mucoactive
- Pulmozyme
- Used to treat CF patients
- Breaks apart DNA and F-actin
Properties of mucus (4)
- Protective
- Lubricative
- Waterproofing
- Entraps microorganisms
General Indication for Mucoactive Therapy
reduce the accumulation of airway secretions, improve pulmonary function/gas exchange, reduce infection/damage
Disease/States for Mucoactive Indication
- CF
- CB (COBP)
- Pneumonia (viral/bacteria)
- Diffuse panbronchiolitis (DPB-emphysema)
- Primary cilia dyskinesia
- Asthma
- Bronchiectasis (over-production)
- Dehydration
Optimal mucus would be…
thin enough to be able to cough out mucus, and thick enough to not slide deeper into alveoli.
Physiology: two layers
- Gel - stickier/drier
- Periciliary layer - wet
- functional surfactant layer sepeartes periciliary fluid from mucus gel
Physiology: surface epithelial cells
- pseudostratified, columnar, ciliated epithelial cells
- surface goblet cells (no direct innervation, 600 goblet cells/mm2 of a normal airway)
- clara cells
Physiology: submucosal glands
- innervated by the parasympathetic system
- provides airway surface mucin, the chemical that makes up sputum
- serous and mucous cells pump out more fluids
4 things to look for when diagnosing sputum
- size
- color
- tenaciousness
- smell
Physiology: ciliary system
- 200 cilia per cell
- effective power stroke
- recovery stroke
4 factors affecting mucociliary system
- COPD
- airway drying
- narcotics
- endotracheal suctioning
Healthy mucus is:
clear, viscoelastic, sticky
A healthy person secretes…
100 mL/day, most of which s reabsorbed in the bronchial mucosa or swallowed w/ saliva
Two major classes or mucin are…
secreted and membrane-tethered mucins (mucus plugs)
5 mucoactive CF drugs
- Dornase alfa (MucoMyst)
- Kalydeco (Ivacaftor)
- Bronchitol (d-mannitol)
- Gelsolin
- Thymosin B4
