Increasing the amount of sputum also increases this cough reflex, which can significantly reduce a patient's quality of life. In the field, it is difficult to understand which drug is what type of expectorant.
Expectorants can be broadly divided into two types: “how to control the amount of secretions” and “how to control the properties of secretions”.
Bromhexine is classified as an airway secretagogue. It has also been found that it has the effect of dissolving the acidic glycoprotein fibrous network to lower the molecular weight. It also works to enhance ciliary movement, and its mechanism of action is complex.
This type of medicine is considered to be very effective for badly sputum. On the other hand, patients with invasive mucinous adenocarcinoma with bronchorrhea (so-called mucinous BAC) should be careful because airway secretions may increase.
Ambroxol is classified as an airway mucosal lubricant. Mainly, it promotes the secretion of pulmonary surfactant, which has the effect of facilitating expectoration.
Ambroxol has a sustained-release drug, and it is said to be effective for patients with strong sputum symptoms who wake up after dinner or before sleep. It is also the drug that has strong evidence for sputum symptoms after surgery.
Carbocysteine is classified as a secretory cell normalizing drug and an airway mucus repair drug. Secretory cell normalizers suppress goblet cell hyperplasia and suppress overproduction of mucus, and airway mucus repair agents exert an expectorant effect by normalizing the ratio of sialic acid to fucose To do.
It is well known that the 2008 PEACE trial reduced the frequency of acute COPD exacerbations.