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Table 1 Mucoactive medications and their presumed actions

From: Secretion properties, clearance, and therapy in airway disease

Mucoactive agent Potential mechanisms of action
Expectorants  
Mannitol powder  
Hypertonic saline Increases secretion volume and perhaps hydration
Classical mucolytics  
N-acetylcysteine Severs disulfide bond linking mucin oligomers
Ambroxil Increases chloride secretion and severs disulfide bonds
Peptide mucolytics  
Dornase alfa Hydrolyzes DNA polymer with reduction in DNA length
Gelsolin or Thymosin β4 Depolymerizes F-actin
Non-destructive mucolytics  
Dextran Breaks hydrogen bonds
Mucoregulatory agents  
Anticholinergic agents Decreases volume of stimulated secretions
Glucocorticoids Decreases airway inflammation and mucin secretion
Indomethacin Decrease airway inflammation
Macrolide antibiotics Decreases airway inflammation and mucin secretion
Cough clearance promoters  
Bronchodilators Can improve cough by increasing expiratory flow
Surfactants Decreases sputum adhesiveness