Mucus-Controlling Therapy

Question 0

Mucus

Answer 0

secreted from surface goblet cells and submucosal glands, composed of water, proteins, and glycosylated mucins

Question 1

Mucin

Answer 1

Principle constituent of mucus

Question 2

Sputum

Answer 2

Expectorated phlegm that contains respiratory tract, oropharyngeal, and nasopharyngeal secretions, and bacteria and products of inflammation including polymeric DNA and actin

Question 3

Phlegm

Answer 3

Purulent material in the airways

Question 4

Sol layer

Answer 4

Has physical property of viscosity, macromolecular description of respiratory secretion in true solution

Question 5

Gel layer

Answer 5

Pseudoplastic material having both viscosity and elasticity

Question 6

Adhesion

Answer 6

forces between UNLIKE molecules (mucus and airway surface)

Question 7

Cohesion

Answer 7

Forces between LIKE molecules (result from the elongation of the mucus macromolecule).

Question 8

Elasticity

Answer 8

Ability of deformed material to return to original shape. Characteristic of solids, represented by the storage modulus G’.

Question 9

Viscosity

Answer 9

Resistance of liquid to sheer forces, characteristic of liquids, represented by loss modulus G’.

Question 10

Mucoactive

Answer 10

Any drug that has an effect on mucus secretion (postural drainage, directed cough, PEP)

Antiproteases, Gravity, cough, insufflation-exsufflation, exercise, high frequency techniques

Contraindicated if profound airflow compromise (FEV1 less than 25%), GERD, inability to protect airway, acute bronchitis, exacerbation of chronic disease.

Question 11

Mucolytics

Answer 11

Degrades polymers in secretions or breaks down the structure of mucus

Dornase Alfa (Pulmozyme) -indicated in CF, reduces extracellular DNA and F-actin polymers)

N-acetylcysteine (Mucomyst) -breaks disulfide bonds…no data demonstrating effectiveness for any lung disease, can be used for acetaminophen overdose (orally), 10 or 20 percent inhaled
concentrations—Pretreat with albuterol to prevent bronchospasm. Incompatible with some antibiotics.

Question 12

Expectorant

Answer 12

Designed to increase the volume or hydration of airway secretions

Iodine containing agents

Guaifenesin aka Mucinex,

Oligosaccharides like Mannitol which is used in neonates to reduce cranial edema)

Hyperosmolar saline

Question 13

Mucoregulatory

Answer 13

reduces the volume of airway mucus, especially effective in hypersecretory states (steroids, anticholinergics (atropine), macrolides),

Question 14

Mucokinetic

Answer 14

Increases the ciliary clearance or improves the mobilization of secretions (bronchodilators, surface active phospholipids) effective in treating chronic bronchitis and CF.

Question 15

Mucospissic

Answer 15

Increases the viscosity of secretions and may be effective in the therapy for bronchorrhea. (decreases “wateryness)),