New strategy of mucolytic therapy in modern medical practice
S.L. Babak, M.V. Gorbunova, A.G. Malyavin
The Department of phthisiology and pulmonology of general medicine Department of A.I. Yevdokimov, Moscow
Long-time medical observations of ambroxol use attract more and more attention nowadays. It is ambroxol, which belongs to mucolytics and solventias (expectorants) is considered to be a substance, having an active influence at basic mechanisms of bronchial mucus pbysiological production and transportation. Due to these features the main indication to its prescribtion is “secretolytic” therapy of acute and chronic pulmonary diseases, associated with tracheobronchial secret hypersecretion and disorder of its transportation. The aim of current review is estimation of pharmacological and clinical data concerning secretolytic and mucokinetic activity of ambroxol and grounding of a new strategy of its use in practice of internal medicine. Retrospective analysis of the results of pharmacological and clinical research works of national and foreign authors for the period from 1967 to 2017 was used. The research data with adequate design from “proper clinical practice” positions (GCP) and evidentary medicine were included. It was made a conclusion, that ambroxol as a medicament has a row of original characteristics including: 1) high secretolytic activity stimulating the mucosal clearance, expectoration of the secret and reduce of productive cough, 2) antiinflammatory and antioxidative activity, 3) local analgesic (anaestetic) effect by means of blocking of sodium channels of cellular membranes. The reduce of frequency of chronic obstructive pulmonary disease recidives proves the significance of ambroxol clinical effects. Effect of tunicas mucosa anaesthesia is related to a new pharmacological effect of ambroxol, which could be useful in acute bronchitis and ARVI infection therapy. The efficacy and safety of ambroxol clinical practice use has been tested by almost half-century experience of its prescribtion. Modern strategy of mucolytic therapy is able to improve significantly the quality of treatment and prognosis of patients with acute and chronic pulmonary diseases with tracheobronchial secret hypersecretion, mucociliar clearance disorders and non-productive cough.
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About the Autors
Sergey L. Babak, MD, professor of the Department of phthisiology and pulmonology of general medicine Department of A.I. Yevdokimov Moscow state university of medicine and dentistry. Address: 127473, Moscow, 20/1 Delegatskaya St. Tel.: +74956096700. E-mail: sergbabak@mail.ru
Marina V. Gorbunova, PhD, assistant professor of the Department of phthisiology and pulmonology of general medicine Department of A.I. Yevdokimov Moscow state university of medicine and dentistry. Address: 127473, Moscow, 20/1 Delegatskaya St. Tel.: +74956096700. E-mail: mgorb@mail.ru
Andrey G. Maliavin, MD, professor of the Department of A.I. Yevdokimov Moscow state university of medicine and dentistry. Address: 127473, Moscow, 20/1 Delegatskaya St. Tel.: +74956096700. E-mail: maliavin@mail.ru
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