Płusa Tadeusz
Pol Merkur Lekarski. 2014 Jan;36(211):48-53.
Inhaled particles or compacted secretions in the respiratory tract cause irritation of mechanoreceptors, subsequent stimulation of afferent fibers of the vagus nerve, triggering the cough reflex. Distribution of drugs used in the treatment of cough takes into account the pharmacokinetic activity, and this mainly affect on bronchial secretions--drugs that act directly, which destroy disulfide bonds mucous glucoproteins using free sulfhydryl groups and digesting enzymes, extracellular DNA, acting indirectly, that modify the secretion of mucus in the way of other mechanisms, as well as acting on the cough reflex (effects on receptors in the bronchial tree). Mucolytics reduce the viscosity of bronchial secretions by interrupting the sulfide bonds in the mucoprotein chain. Mucokinetic drugs are designed to reduce the adhesion of secretions and facilitate the process of mucociliary clearance by enhancing the potency of cilia. One of the ways of the increasing process is the stimulation of secretion by human neutrophil elastase gene and protein expression regulating this process. The pharmacokinetic properties of these drugs show their high clinical utility and effectiveness in the treatment of respiratory secretions dense clutter. This is possible to reduce the viscosity of mucus by bromhexine. This is obtained by acid depolymerization of the polysaccharide fibers in the bronchial secretions. Synergistic effect with antibiotics of these preparations indicates their permanent place in the treatment of patients with respiratory pathology.
呼吸道中的吸入颗粒或浓缩分泌物会刺激机械感受器,随后刺激迷走神经的传入纤维,引发咳嗽反射。用于治疗咳嗽的药物分布考虑到药代动力学活性,这主要影响支气管分泌物——直接作用的药物,利用游离巯基破坏粘蛋白糖蛋白的二硫键并消化酶、细胞外DNA;间接作用的药物,通过其他机制改变粘液分泌,以及作用于咳嗽反射(对支气管树中的受体产生影响)。粘液溶解剂通过中断粘蛋白链中的硫化键来降低支气管分泌物的粘度。促粘液运动药物旨在减少分泌物的粘附,并通过增强纤毛的效力来促进粘液纤毛清除过程。增加该过程的一种方法是通过调节人中性粒细胞弹性蛋白酶基因和蛋白表达来刺激分泌。这些药物的药代动力学特性显示出它们在治疗呼吸道分泌物浓稠紊乱方面具有很高的临床实用性和有效性。溴己新可以降低粘液的粘度。这是通过支气管分泌物中多糖纤维的酸解聚获得的。这些制剂与抗生素的协同作用表明它们在治疗呼吸道疾病患者中占有永久地位。