RATIONAL MUSCOLYTIC THERAPY IN THE THERAPEUTIC PRACTICE


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Abstract

Long-term medical observations of the use of ambroxol show that, in addition to expectorative effect, it actively affects the basic mechanisms of physiological production and transport of bronchial mucus. The leading indication for the use of ambroxol is secretolityc therapy of acute and chronic bronchopulmonary diseases associated with abnormal mucus secretion and disruption of its transport. The purpose of this analysis is a modern assessment of the chemical, pharmacological and clinical data on the secretolityc and mucokinetic activity of ambroxol with the justification of its importance for modern mucolytic therapy. Methods. In this paper, a method of analysis of the results of publications on the pharmacological and clinical properties of ambroxol in domestic and foreign sources for the period from 1977 to 2017 was used. The analysis included the results of studies with adequate design from the standpoint of «good clinical practice» (GCP) and evidence-based medicine. Conclusion. The substance ambroxol has a number of the following properties: 1) high secretolytic activity (promotes mucus clearance, facilitates expectoration of sputum, reduces productive cough); 2) antiinflammatory and antioxidant activity; 3) local analgesic (anesthetic) effect through blockade of sodium channels of cell membranes. The reduction in the number of exacerbations of chronic obstructive pulmonary disease serves as evidence of the importance of the clinical effects of ambroxol. The effect of mucosal anesthesia is attributed to the new pharmacological action of ambroxol, useful in the therapy of acute respiratory tract infections. The effecacy and safety of ambroxol in clinical practice is confirmed by the half-century experience of its use. Modern mucolytic therapy can significantly improve the quality of treatment and the prognosis for patients with hypersecretion of the tracheobronchial secretion, mucociliary clearance disorders and unproductive cough.

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About the authors

S. L Babak

Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov

Email: sergbabak@mail.ru
MD, Professor of the Department of Phthisiology and Pulmo-nology, Medical Faculty

M. V Gorbunova

Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov

A. G Malyavi

Moscow State University of Medicine and Dentistry n.a. A.I. Evdokimov

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