Mucolytics: ib daim ntawv teev cov khoom uas siv rau cov me nyuam thiab cov laus

Thaum Ari, peb yog feem ntau ntsib nrog xws li tsis kaj siab tshwm sim, xws li hnoos. Nws yog exhausting thiab annoying, tsis yooj yim rau ua tsis taus pa thiab thiaj li muaj lub neej zoo. Rau cov kws kho mob, nws yog ib qho tseem ceeb los mus txiav txim yog dab tsi hom ntawm hnoos nyob rau hauv cov neeg mob: qhuav los yog ntub. Tus thawj hom yog xav tau counter-tsim thiab yog yus muaj los ntawm teeb meem nyob rau expectoration. Hnoos yog hu ua tsim thiab shortens tus neeg mob lub rov qab. Nrhiav tus neeg mob hom qhuav hnoos, cov kws kho mob feem ntau muab tshuaj uas razzhizhzhayut khov txheej secretion, uas yog tsim nyob rau hauv lub ua pa ib ntsuj av. Vim lub high ceev ntawm no hnoos qeev tus neeg mob muaj kev nyuaj nrog hnoos qeev los yog expectoration.

Yuav ua li cas yog cov mucolytics?

Nyob rau hauv thiaj li yuav pab tus neeg mob nrog ib tug hnoos qhuav, tus kws kho mob yuav feem ntau yog muab mucolytics. Daim ntawv teev cov khoom muaj nyob rau hauv pab pawg neeg no yog heev kim heev. Los ntawm txoj kev ntawm lub hwj rau tib neeg lub cev cov tshuaj yuav tsum tau muab faib mus rau hauv peb pab neeg:

• Mucoregulatory tshuaj. Lawv muaj ib feem nyob rau tus nqi tso txheej secretion. Qhov no pab pawg neeg no muaj xws li corticosteroids, thiab M-holinoblokatory karbotsistein.
• Mukokinetiki - yog cov tshuaj uas txhim kho lub expectoration ntawm hnoos qeev. Cov no muaj xws ambroxol, bromhexine thiab li ntawd.
• Ncaj qha mucolytics. Cov tshuaj pab rau cov liquefaction ntawm mucin los ntawm kev txo nws viscosity. Los ntawm mucolytics xws li proteolytic enzymes, acetylcysteine, thiab li ntawd.

Ntau mechanisms liquefaction ntawm hnoos qeev

Yog hais tias peb xav txog lub mechanism uas cov molecule ntawm acid mucopolysaccharides hnoos qeev kua ntawm tus txiv neej muaj peev xwm raug puas tsuaj los nrog kev pab los ntawm cov tshuaj, lub ob lub ntsiab tseem khiav yuav ua tau distinguished - yog ib qho enzyme txoj kev thiab cov uas tsis-enzymatic txoj kev. Nyob rau hauv thawj cov ntaub ntawv, cov enzymes zom cov nqaijrog kev sib txuas lus, thiab nyob rau hauv lwm yam - disulfide linkages nyob rau hauv lub lwg me me ntawm hnoos qeev.

Ib suam ntawm lub ntsiab active tivthaiv

Tag nrho cov ntawm cov tshuaj ua ke raws li lub thoob ntiaj teb kev faib ntawm cov tshuaj ATC nyob rau hauv lub code los yog ATS R05CB «Mucolytics". Daim ntawv teev cov loj active cov khoom xyaw kuj muaj tej alphanumeric los:

• R05CB01 - acetylcysteine.
• R05CB02 - bromhexine.
• R05CB03 - karbotsistein.
• R05CB06 - ambroxol.
• R05CB10 - tshuaj nrog ib tug ua ke formulation.
• R05CB13 - Dornase Alfa (DNase).

Uas tshuaj, mucolytics cob rau ib tug neeg mob, daws tsuas tus kws kho mob. Qhov no lub sij hawm nws tau ua tsuas yog tom qab ib tug meej kev xeem, thiab coj los ntawm cov kev tshwm sim ntawm lub duas paub ntsuam. Cia wb mus ze zog saib yuav ua li cas txhua yam kom nquag plias yam khoom uas muaj pharmacists nyob rau hauv R05CB pab pawg neeg.

Mucolytics nrog acetylcysteine

Acetylcysteine zoo pab nyias cov hnoos qeev, thiab yog li ntawd twb muaj nyob rau hauv cov pab pawg neeg ntawm mucolytics. Daim ntawv teev cov tshuaj muaj tus nquag tshuaj suav txog ob lub kaum os ntau yam ntawm cov tshuaj cov ntaub ntawv. Acetylcysteine yog yus muaj los ntawm cov nram qab no mechanisms ntawm kev txiav txim:

• Nws muaj nyob rau hauv nws cov molecule ib reactive sulfhydryl pab pawg neeg txawv, uas ua rau cov tug mucopolysaccharides disulfide tebchaw vim hais tias ntawm cov uas yog yus muaj los ntawm ntau zog hnoos qeev viscosity. Raws li ib tug tshwm sim, qhov hnoos qeev yog liquefied thiab tas los rau ntawm lub cev yooj yim dua.
• Qhov no cov ntaub ntawv uas muaj txhawb kom txo tau kev ua si thiab thiaj li muaj cov xov tooj ntawm pathogenic cov kab mob uas nyob rau ntawm lub mucosa ntawm lub pa kabmob.
• Nws muaj antioxidant zog. Sulfhydryl pawg hnov mob nrog dawb radicals thiab metabolites ntawm oxygen thiab tshem tawm lawv los ntawm lub cev. Yog li, acetylcysteine muaj ib tug antiinflammatory kev txiav txim thiab ovobozhdaet lub cev los ntawm tshuaj lom tshuaj, considerably easing tus neeg mob tus mob.

Los ntawm kev npaj muaj raws li active tshuaj acetylcysteine, tej zaum yuav hais li no:

• "Mukobene" - cov ntsiav tshuaj; 100, 200 los yog 600 mg.
• "Mukomist" - daws nyob rau hauv ampoules, 20% rau cov kev tshuaj pleev thiab nqus tau pa.
• "Mukoneks" nyob rau hauv daim ntawv ntawm pellets, 0.1 g los npaj ib tug phoov.
• "Fluimucil" nyob rau hauv daim ntawv ntawm pellets, 100 thiab 200 mg; Ntsiav tshuaj rau fizzy haus, 600 mg.
• "ACC" nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj npaj effervescent haus - 100, 200, 600 mg; txhaj 300 mg / 3 ml nyob rau hauv ampoules; granules rau daws nyob rau hauv, 100, 200 mg.
• "Acetylcysteine" nyob rau hauv cov hmoov daim ntawv no, 200 mg; tshuaj cov kev txhaj tshuaj, 10%; tov rau ngalyatsy, 20%;
• "Atsestin" - Ntsiav tshuaj rau hauv cov thawj coj, 100, 200, 600 mg; Ntsiav tshuaj rau fizzy haus, 200 thiab 600 mg.

Acetylcysteine thiab tshuaj nrog nws txhob nyob rau hauv cov me nyuam nyob rau hauv hnub nyoog 2 xyoos (thiab ib co - mus txog rau 6 xyoo), cev xeeb tub thiab lactating cov poj niam, cov neeg uas ulcerative hnyuv kab mob nyob rau hauv lub mob nyob ntev. Tej zaum koj yuav muaj kev phiv xws li mob taub hau, stomatitis, nkees thiab tinnitus, tsis tshua manifested gastrointestinal mob, ua xua, tachycardia. Acetylcysteine yuav tsis haus dej haus nrog antitussive tshuaj. Nws kuj pab tau cov nyhuv ntawm nitroglycerin thiab cheeb qhov uas cov haum ntawm tshuaj tua kab mob.

Mucolytics nrog bromhexine

Medicaments muaj no substance li cov active tivthaiv, feem ntau muab los ntawm kev hnoos, thiab positioned raws li mucolytics. Daim ntawv teev cov tshuaj no tsuas siv mus rau tsib cov kws tshuaj. Ib zaug nyob rau tib neeg lub cev, bromhexine proceeds raws li nram no:

• lowers tus viscosity ntawm bronchial secretion los ntawm hnoos qeev polysaccharides depolarization;
• Nws nkoos mucosal bronchial hlwb uas paim polysaccharides nruab nrab hom;
• Nws yeej txhawb lub tsim ntawm ib tug surfactant;
• Nws ua expectorant cov nyhuv;
• cheeb qhov uas cov hnoos reflex.

Npaj-mucolytics nram qab no muaj raws li ib tug lub ntsiab active khoom sib ua zaub mov bromhexine. Cov muaj xws li:

• "Solvin" - tov rau hauv cov thawj coj, 4 mg / 5 ml; ntsiav tshuaj rau qhov ncauj siv, 8 mg.
• "Bromhexine" nyob rau hauv daim ntawv ntawm cov tshuaj, 4 mg / 5 ml; phoov, 4 mg / 5 ml; ntsiav tshuaj 8 mg.

Yeeb siv tshuaj, mucolytics, muaj bromhexine, yog contraindicated rau cov neeg uas muaj ib tug neeg intolerance rau qhov no kev tivthaiv, zoo li cov me nyuam mus txog 6 xyoo. Lawv muaj peev xwm ua rau kem plab, mob taub hau, sib cais ntawm hws, daim tawv nqaij ua pob ua xyua thiab bronchospasm. Cev Xeeb Tub thiab lactating cov poj niam noj tshuaj nrog bromhexine tsa tsis tshua.

Tshuaj nrog carbocisteine

Qhov no tshuaj yog tseem muaj nyob rau hauv lub "Mucolytics" pab pawg neeg. Daim ntawv teev cov tshuaj nrog carbocisteine suav txog kaum yam khoom, tab sis tag nrho lawv muaj tib lub kws nyhuv:

• txo cov ntsiab lus ntawm nruab nrab thiab acidic nce zus tau tej cov glycopeptides yog coj mus rau hauv lawv tej kev faib ua feem;
• txo cov viscosity thiab kho cov elasticity ntawm hnoos qeev;
• tsim dua tshiab lub mucosa ntawm lub pa system thiab restore qhov qub qauv;
• kom qhov zoo tshaj yuav ntawm lub zos cov kev kuj lgA;
• normalize xaiv sulfigrilnyh pawg;
• stepping li cov kev ua ntawm ciliated bronchial epithelium.

Heev feem ntau, cov neeg mob raug xwb xws li mucolytics. Ib daim ntawv ntawm cov tshuaj thiab cov kev npaj muaj karbotsistein yog muab hauv qab:

• "Libeksin Muko" nyob rau hauv daim ntawv ntawm ib tug phoov, 50 mg / ml.
• "Mucodyne" nyob rau hauv daim ntawv ntawm cov tshuaj, 125 mg; phoov rau cov me nyuam 125 mg / 5 mL thiab 250 mg / 5 ml.
• "Karbotsistein" phoov 250 mg / 5 mL thiab 125 mg / 5 mL (rau cov me nyuam); Tsiav tshuaj, 375 mg.
• "Fluifort" nyob rau hauv daim ntawv ntawm granules rau ncua kev kawm ntawv, 2.7 mg; Syrup, 90 mg / l; phoov 2% (rau cov me nyuam) thiab 5%.

Karbotsisteinovye mucolytics, tshuaj thiab cov tshuaj noj, uas yog piav los saum no yuav tsis tau noj nrog lub fact muaj ib tug haum cov thawj tivthaiv raws li zoo raws li nyob rau hauv peptic rwj kab mob, teeb ntawm lub cev funktsionirovaniyapochek, glomerulonephritis nyob rau hauv lub mob hauv daim ntawv, cystitis, cev xeeb tub thiab pub niam mis. Npaj nyob rau hauv daim ntawv ntawm cov tshuaj yog contraindicated rau cov me nyuam nyob rau hauv 12 lub xyoos, thiab nyob rau hauv daim ntawv ntawm cov phoov - txog li 2 lub xyoos. Yeeb siv tshuaj, mucolytics Hnoos raws li karbotsisteina yuav sporovotsirovat rastrojstva zom cov zaub mov thiab kev tsis haum ces.

Tshuaj nrog ambroxol

Cov tshuaj no yog cov feem ntau nrov ntawm cov neeg mob. Ambroxol muaj cov nram qab los rau tib neeg lub cev:

• Nws thiaj li viscosity Performance index thiab cov adhesion ntawm hnoos qeev;
• tswj paug hnoos qeev los ntawm cov hlab cua;
• activates serous hlwb ntawm lub bronchial mucosa ntawm lub glandular cov ntaub so ntswg;
• Nws nkoos zus tau tej cov enzymes uas thuam cov qauv ntawm cov polysaccharides ntawm hnoos qeev;
• nquag txhawb zus tau tej cov surfactant;
• Nws nkoos cilia ntawm lub bronchi thiab tiv thaiv lawv los ntawm so ua ke.

Vim qhov kev txiav txim ntawm cov yam tseem ceeb ambrokola nws twb muaj nyob rau hauv cov pab pawg neeg "Mucolytics". Ib daim ntawv teev cov tshuaj uas muaj qhov no kev tivthaiv yog nws kim heev. Ntawm no yog cov feem ntau cov tshuaj nrog ambroxol:

• "Mucosolvan" - lozenges, 20 mg; pastilles 15 mg; tov, 7.5 mg / ml; phoov 15 thiab 30 mg / 5 ml; ntsiav tshuaj, 30 mg.
• "Haliksol" - nyob rau hauv daim ntawv ntawm ib tug phoov, 30 mg / ml thiab 10 ntsiav tshuaj, 30 mg.
• "Maddox" - nyob rau hauv daim ntawv ntawm ib tug phoov, 15 mg / 5 ml thiab cov ntsiav tshuaj, 30 mg.
• "Deflegmin" - nyob rau hauv daim ntawv ntawm cov tshuaj rau qhov ncauj cov thawj coj, ntsiav tshuaj thiab 0.75%, 30 mg;
• "Suprema-COF" - nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
• "Mukobron" -to daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
• "Ncos Bronhovern" - tov rau hauv cov thawj coj, 7.5 mg / ml.
• "Ambrobene" - nyob rau hauv daim ntawv ntawm cov tshuaj, 75 mg; tshuaj cov kev txhaj tshuaj, 7.5 mg / ml; phoov, 15 mg / 5 ml; ntsiav tshuaj, 30 mg.
• "Ambrogeksal" - nyob rau hauv daim ntawv ntawm cov tshuaj, 75 mg; tov rau nqus tau pa thiab haus, 7.5 mg / ml; phoov 3 thiab 6 mg / ml thiab cov ntsiav tshuaj, 30 mg.
• "Ambroxol" - nyob rau hauv daim ntawv ntawm ib tug phoov, 3 thiab 6 mg / ml; ntsiav tshuaj, tshuaj, 30 mg thiab 75 mg.
• "Ambrolap" - nyob rau hauv daim ntawv ntawm cov tshuaj, 75 mg; phoov, 15 mg / 5 ml; ntsiav tshuaj, 30 mg; rastvoa rau sab hauv tsev txais tos thiab rau inhalation, 7.5 mg / ml.
• "Ambrosan" - nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
• "Ambrosol" - raws li ib tug phoov 0.3 thiab 0.6 g / 100 ml.
• "Remebroks" -to tsim ib phoov 30 mg / 5 ml.
• "Ambrotard 75" -to daim ntawv ntawm tsiav tshuaj, 75 mg.
• "Flavamed" - nyob rau hauv daim ntawv ntawm ib tug tov rau qhov ncauj cov thawj coj, 15 mg / 5 ml thiab cov ntsiav tshuaj, 30 mg.
• "Bronhoval" - Ntsiav tshuaj, 30 mg; Syrup, 15 mg / 5 ml.

Nyob rau hauv daim ntawv ntawm qhov kev tso tawm ntawm cov tshuaj, muaj contraindications mus rau lub txais tos ntawm lub hauv paus ntawm ambroxol tshuaj. Tej npaj, mucolytics rau cov me nyuam uas muaj 2 xyoos haum tsuas yog tias ntau npaum ntawm lub active tshuaj tsis pub tshaj 3 mg / ml, feem ntau yog lub syrup los yog tshuaj. Cov ntsiav tshuaj yuav tsis haus dej haus rau cov neeg mob nyob rau hauv lub hnub nyoog ntawm 6 xyoo, lub tshuaj ntsiav - mus txog rau 14 xyoo. Tsis tas li ntawd, yog hais tias tus neeg mob koj yog hypersensitive rau ambroxol, mucolytics cov ntaub ntawv yuav tsis raug muab tso. Ntawm cov kev phiv los ntawm cov tshuaj - indigestion, nce sib cais los ntawm qhov ntswg hnoos qeev, teeb meem tso zis, allergic kev tig cev. Thaum uas cev xeeb tub feem ntau yog ambroksol tsis muab nyob rau hauv thawj peb lub hlis, thiab nyob ib tug tom qab hnub tim - tsuas yog nyob rau tus kws kho mob lub tswv yim.

Mucolytics ua ke pes tsawg leeg

Cov medicaments muaj ntau ntau yam active tshuaj los ntawm qhov kev txiav txim, uas muab liquefaction ntawm hnoos qeev, li ntawd, lawv twb muaj nyob rau hauv lub typology "Mucolytics". Thaum qhuav hnoos daim ntawv teev cov tshuaj los ntawm ib tug kws kho mob los ntawm daim ntawv yav tas los piav nyob rau hauv no tsab xov xwm, yuav supplemented nrog cov nram qab no cov tshuaj:

• "Sinupret" - txhais tau tias ib tsob nroj lub Cheebtsam. Nws muaj ib tug ib feem ntawm gentian paus, primrose paj thiab elderberry tshuaj ntsuab sorrel thiab vervain. Cov kev npaj no yog ua nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj los sis dej tov. active tshuaj complex tswj npaum paug hnoos qeev los ntawm qhov sinuses thiab Upper pa ib ntsuj av. Lub ob formulations yuav tsis tau cov me nyuam mus txog hnub nyoog 6 xyoo thiab cov neeg uas lactase tsis muaj peev xwm, raws li zoo raws li lub xub ntiag ntawm haum cov tshuaj Cheebtsam.
• "Rinikold Broncho" - kev npaj uas sib txuas ntxiv ntawm cov peb lub ntsiab Cheebtsam: ambroxol (15 mg), chlorphenamine (2 mg), phenylephrine (5 mg) thiab guaifenesin (100 mg). Raws li ib tug tshwm sim uas tau txais no phoov viscosity txo hnoos qeev nyob rau hauv lub bronchi, yooj yim expectoration, eliminates tearing, khaus ntawm lub qhov muag thiab qhov ntswg, decreases o thiab liab ntawm lub qog ua kua nqaij ntawm qhov ua pa system. Cov tshuaj yog ua rau chua, atherosclerosis, kub siab, ntshav qab zib, hyperthyroidism, pheochromocytoma, glaucoma, kaw-hom, pais plab, prostate adenoma, tsis muaj peev xwm ntawm glucose-6-phosphate dehydrogenase, cev xeeb tub thiab lactation, cov me nyuam nyob rau hauv 6 xyoo yog tsis haum rau lub Cheebtsam. Koj muaj peev xwm tsis haus dej haus lub syrup nrog betaadrenoblokatorami, tricyclic antidepressants hom, Mao inhibitors thiab tshuaj uas muaj tib lub active tshuaj raws li lub "Broncho Rinikold".

Ribonuclease rau cov kev kho mob ntawm qhuav hnoos

Feem ntau cov kws kho qhov kws kho mob mucolytics nrog hnoos qhuav, ib daim ntawv teev cov neeg uas tau hais ua ntej lawm, nws yuav tsum tau ntaus nqi rau cov tshuaj tshuaj thiab kuaj los ntawm lub sij hawm. Brand tshiab thiab niaj hnub txoj kev ntawm tau txais tshem ntawm khov hnoos qeev nyob rau hauv lub ua pa ib ntsuj av tau - siv ntawm ribonuclease los yog dornase Alfa. Qhov no tshuaj yog ib tug txhob kaw engineered khoom, ib tug analogue ntawm lub ntuj tib neeg enzyme uas yog lub luag hauj lwm rau cleavage ntawm cov extracellular DNA.

Nyob rau hauv lub xub ntiag ntawm cystic fibrosis nyob rau hauv ib tug neeg mob, uas yog yus muaj los ntawm ib tug ntse kab txheej txheem, ib tug txuam nrog ntawm purulent kua uas muaj viscosity. Raws li ib tug tshwm sim, cov neeg mob tsis hnov ua pa muaj nuj nqi. Nyob rau hauv purulent kua nyob rau hauv loj qhov ntau muaj extracellular DNA. Cov hais yog tso tawm los ntawm lub lwj leukocytes ua raws li ib lo lus teb mechanism nyob rau hauv cov kab mob thiab muaj lub siab viscosity. Ribonuclease cleaves DNA hydrolytic los ntawm phlegm thiab hnoos qeev resulting liquefied.

Dornase Alfa yog ib feem ntawm lub "Pulmozyme" yeeb tshuaj, uas yog nyob rau hauv daim ntawv ntawm ib tug tov rau nqus tau pa. Active teeb meem cov ntsiab lus - 2.5 mg / 2.5 ml. Qhov no tshuaj muaj tau ntse siv nrog cystic fibrosis thiab mob obstructive koj muaj teebmeem kev kab mob: bronchiectasis mob, COPD, congenital malformations nyob rau hauv cov me nyuam, mob ntsws, ua pa txhab immunodifitsitnogo cim.

Contraindications "Pulmozim" me ntsis. Cov tshuaj yuav tsum tsis txhob muab rau cev xeeb tub thiab lactating cov poj niam thiab cov me nyuam hnub nyoog 5 xyoos. Sab los nyob rau hauv cov kev kho mob ntawm qhov cuab tam yog tsawg tsawg thiab tej zaum yuav tshwm sim raws li ib tug lymphocytic leukemia mob ntaub ntawv ntawm aplastic anemia, qaug dab peg, migraine, conjunctivitis, disequilibrium, tachycardia, cardiac ntes, bradycardia, mob ntsws, bronchospasm, digestive mob, allergic dermatitis, angioneurotic edema, mob cev xeeb tub thiab yug menyuam, mob hauv siab, tsis muaj zog.

Kho kom sai thiab kom

Hauv tsab xov xwm no tau muab xav los xav: "Kev npaj dab tsi yog cov mucolytics?" Daim ntawv teev cov tshuaj yeeb uas feem ntau ntawm pawg neeg no tau hu ua. Nws yuav tsum tau qhia tshwj xeeb uas tau sau tseg tias lub hom phiaj ntawm kev siv tshuaj, nws cov tshuaj, thiab cov lus pom zoo rau lub sijhawm kho mob thiab qhov kev hloov ntawm cov tshuaj nrog ib qho analog yog cov teeb meem uas muaj peev xwm ntawm ib tus kws kho mob tshwj xeeb tom qab ib qho kev kuaj mob ntawm tus neeg mob. Kev siv tshuaj rau tus kheej no yuav tsis yog siv tsis tau xwb, tab sis kuj tseem tuaj yeem ua rau kom tsis tuaj yeem ua rau: los ntawm cov kev mob tshwm sim ntawm kev siv tshuaj mus rau kev loj hlob ntawm cov kab mob mus ntev. Yog li, yog tias koj muaj cov tsos mob ntawm tus mob, tsis txhob ncua kev mus ntsib tus kws kho mob. Noj qab nyob zoo!