Mucolytics

Mucolytics are prescribed to facilitate expectoration by reducing sputum viscosity. In some patients with chronic obstructive pulmonary disease and a chronic productive cough, mucolytics can reduce exacerbations; mucolytic therapy should be stopped if there is no benefit after a 4-week trial. Steam inhalation with postural drainage is effective in bronchiectasis and in some cases of chronic bronchitis.

Mucolytics should be used with caution in those with a history of peptic ulceration because they may disrupt the gastric mucosal barrier.

CARBOCISTEINE:

Indications: reduction of sputum viscosity

Contraindications: active peptic ulceration

Dose and Administration: Initially 2.25 g daily in divided doses, then 1.5 g daily in divided doses as condition improves; child 2–5 years 62.5–125 mg 4 times daily, 5–12 years 250 mg 3 times daily

AMBROXOL HCL:

Indications: All forms of tracheobronchitis, emphysema with bronchitis pneumoconiosis, chronic inflammatory pulmonary conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis it should be given with the appropriate antibiotic.

Contraindications: There are no absolute contraindications but in patients with gastric ulceration relative caution should be observed.

Dose and Administration:

Adults: daily dose of 30 mg to 120 mg taken in 2 to 3 divided doses.

Children up to 2 years: 7.5MG twice daily.

Children 2 – 5 years: 7.5MG 3 times daily.

Children over 5 years: 15MG 2-3 times daily.

BROMHEXINE HCL:

Indications:

Reduces the viscosity of mucus in the tracheobronchial tree; this is expected to make carriage of mucus up the tracheobronchial tree by the mucociliary clearance mechanism easier, and also to increase ease of expectoration of mucus during coughing.

To assist in control of respiratory disease involving production of excessive tenacious mucus.

Contraindications: There are no absolute contraindications but in patients with gastric ulceration relative caution should be observed.

Dose and Administration:

Adults, 5-10ml 3 times daily.

Children over 8 years 5ml 3 times daily.

Infant’s 1.25ml 3 times daily.

CARBOCISTEINE, PROMETHAZINE:

Indications: it is recommended for the alleviation of unproductive and irritative

coughs in adults and children aged over 1 year.

Contraindications: former or recent agranulocytosis.

Dose and Administration:

Adults 15ml 3-4 times daily.

Infants 5ml 3-4 times daily.