Mucolytics

Mucolytics are used in the reduction of sputum viscosity, and thus are given to help expectoration in chronic asthma and bronchitis.

Types of mucolytics, listed as synonyms, include:

• acetlycysteine
• carbocisteine
• methylcysteine hydrochloride

Chronic obstructive pulmonary disease (COPD) is characterised by airflow limitation, and pathophysiologically involves many components including mucus hypersecretion, oxidative stress, and inflammation in the airway and lungs

• in Europe and Asia, mucolytics such as carbocisteine have been widely used for treatment of respiratory diseases with phlegm production because of their capacity to facilitate sputum elimination
  • carbocisteine seems likely to have a role in antioxidation and and anti-inflammation that might be more important than mucolysis itself for long-term management of COPD
  • clinical studies have shown benefits in preventing exacerbation of COPD with carbocisteine
• the PEACE study revealed that:
  • 1-year management of carbocisteine was effective for COPD patients in terms of reductions in exacerbations and improvements in quality of life
  • no interactions between treatment and COPD severity, smoking status, and concomitant use of inhaled corticosteroids
  • authors concluded that mucolytics, such as carbocisteine, should be recognised as a worthwhile treatment for the long-term management of COPD

Reference:

• 1. Zheng JP et al. Effect of carbocisteine on acute exacerbation of chronic obstructive pulmonary disease (PEACE Study): a randomised placebo-controlled study. Lancet. 2008 Jun 14;371(9629):2013-8.