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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