The main feature of mucolytics is their expectorant action by reducing the toughness of the secretion. Because of this property, they are to be distinguished from the other expectorants.
In addition to the mucolytics, the expectorants also include the secretolytics and the secretomotor moieties. While the secretolytic agents promote the formation of fluid secretions secretomotor moieties are responsible for the increased removal of mucus by the increased movement of the cilia.
The mucolytics start at a completely different place. They alter the consistency of the secretion through chemical, biological or physical processes.
The mucolytics include such diverse biochemical agents as acetylcysteine, carbocysteine, mesna, carbocysteine, bromhexine, fennel and aniseed oil or myrole.
The liquefaction of the secretion does not take place via a uniform mechanism of action, but each active substance intervenes here via its own mechanism. Thus, acetylcysteine chemically alters the secretion by breaking down sulfide bridges between the mucopolysaccharide fibers. As an alternative mechanism is discussed here that the inflammatory processes are inhibited by the direct antioxidant action of acetylcysteine, whereby the secretion liquefies.
Carbocysteine, in turn, intervenes intracellularly, shifting the ratio of fluid to viscous mucus in favor of the fluid secretion during secretion production. The drug guaifenesin is intended to cause the parasympathetic stimulation of the bronchial glands by a reflex irritation of the gastric mucosa, so that a thin liquid secretion arises. Mesna alters secretory consistency via the same mechanism as acetylcysteine.
However, today it is mainly used as a drug for detoxification during chemotherapy, but less so than mucolytics. Bromhexin again favors another mechanism of action. It stimulates the formation of enzymes that degrade the secretion under liquefaction. The herbal ingredients fennel and aniseed unfold their expectorant effect through the influence of essential oils.
Myrtol is a mixed oil of various essential oils, which has a very good expectorant effect on acute bronchitis. However, the mechanism of action for mucus solution via the essential oils has not yet been fully elucidated.
In the following, some frequently used medicines are to be considered closer to their effect. Acetylcysteine as an important mucolytic is often used in chronic bronchitis or COPD for mucus solution.
The positive effect especially with COPD has been proven by many years of research. The extent to which acetylcysteine leads to a lasting improvement in the state of health in chronic bronchitis must be confirmed by further studies. However, the use of acetylcysteine in cystic fibrosis gives good results. Bromhexine is also regularly used as mucolytics as another active ingredient. Bromhexine is used in both acute and chronic respiratory diseases such as bronchitis, asthma, common cold, COPD, emphysema or cystic fibrosis for mucus solution.
It is administered in the form of tablets, drops or juice. Essential oils are also used in respiratory diseases for the inhibition of inflammation and mucus solution. Here is especially the mixed oil Myrtol to call. Myrtol is enclosed in capsules and is also given in this form. In addition to bronchitis, it is also used as a mucolytic in sinusitis. In addition to these commonly used drugs, there are a variety of other mucolytics.
It can cause headaches, itchy skin and runny nose. In addition, use in asthma and gastric ulcers is contraindicated. Furthermore, acetylcysteine should not be given in children less than 2 years old. Bromhexine is contraindicated in hypersensitivity.
It should only be given under medical supervision for gastric and duodenal ulcers as it may irritate the stomach and intestines. Even with renal and hepatic insufficiency, it should only be used under medical supervision. Essential oils such as Myrtol should not be used in cases of hypersensitivity, gastric and intestinal problems and bile disorders.