Nrog rau tus kab mob ua pa hnyav, peb feem ntau ntsib qhov tshwm sim tsis zoo li hnoos. Nws tuaj yeem ua rau qaug zog thiab cuam tshuam, ua rau ua pa nyuaj thiab txo qis lub neej zoo. Nws yog ib qho tseem ceeb heev rau tus kws kho mob los txiav txim seb tus neeg mob hnoos qhuav los yog ntub dej. Thawj hom yog suav hais tias yog tsis tsim nyog thiab yog tus cwj pwm los ntawm kev nyuaj ntawm cov hnoos qeev tawm. Kev hnoos ntub yog hu ua tsim khoom thiab ua rau tus neeg mob lub sijhawm rov zoo. Tau pom ib hom hnoos qhuav nyob rau hauv tus neeg mob, cov kws kho mob feem ntau sau cov tshuaj uas ua rau cov hnoos qeev uas ua rau hauv lub ntsws. Vim muaj qhov ntom ntom ntawm cov hnoos qeev no, tus neeg mob muaj teeb meem dhau ntawm hnoos qeev lossis expectorating.
YDab tsi yog mucolytics?
Txhawm rau pab tus neeg mob hnoos qhuav, tus kws kho mob feem ntau sau tshuaj mucolytics.
Cov npe tshuaj suav nrog hauv pab pawg no yog qhov dav heev. Raws li txoj kev uas lawv cuam tshuam rau tib neeg lub cev, cov tshuaj no tuaj yeem muab faib ua peb pawg:
- Mucoregulatory tshuaj. Lawv cuam tshuam rau cov hnoos qeev tso tawm. Cov pab pawg no suav nrog glucocorticosteroids,M-anticholinergics thiab carbocysteine
- Mucokinetics yog cov tshuaj uas ua kom cov hnoos qeev ntws zoo. Cov no suav nrog ambroxol, bromhexine, thiab lwm yam.
- Ncaj nraim mucolytics. Cov tshuaj no pab ua kom cov tawv nqaij ntawm cov mucous secretion los ntawm kev txo nws cov viscosity. Mucolytics suav nrog cov enzymes proteolytic, acetylcysteine, thiab lwm yam.
Different mechanisms ntawm hnoos qeev
Yog tias peb xav txog cov txheej txheem uas cov molecules ntawm cov kua qaub mucopolysaccharides ntawm tib neeg cov mucosaccharides tuaj yeem rhuav tshem nrog kev pab ntawm cov tshuaj, peb tuaj yeem paub qhov txawv ntawm ob txoj hauv kev - qhov no yog txoj kev enzymatic thiab tsis yog enzymatic. Hauv thawj kis, enzymes rhuav tshem cov ntawv cog lus protein, thiab hauv lwm qhov, cov txuas hniav disulfide hauv cov hnoos qeev molecules.
Kev faib tawm los ntawm cov khoom xyaw tseem ceeb
Tag nrho cov tshuaj no tau ua ke raws li kev faib tawm thoob ntiaj teb cov tshuaj ATC lossis ATC raws li txoj cai R05CB "Mucolitics". Cov npe ntawm cov khoom xyaw tseem ceeb tseem muab rau ib tsab ntawv tshwj xeeb thiab tus lej tsim:
- R05CB01 - acetylcysteine.
- R05CB02 - Bromhexine.
- R05CB03 - carbocysteine.
- R05CB06 - Ambroxol.
- R05CB10 - tshuaj nrog kev sib xyaw ua ke.
- R05CB13 - Dornase alfa (deoxyribonuclease).
Tsuas yog tus kws kho mob txiav txim siab seb cov tshuaj mucolytic yuav muab rau tus neeg mob twg.
Nws ua qhov kev teem caij no tsuas yog tom qab kev kuaj xyuas nruj thiab coj los ntawm cov txiaj ntsig ntawm cov kev xeem cuam tshuam. cia pebCia wb mus saib seb yuav ua li cas txhua yam tshuaj nquag suav nrog los ntawm cov kws muag tshuaj hauv pawg R05CB ua haujlwm.
Acetylcysteine mucolytics
Acetylcysteine yog siv tau rau hauv cov phlegm thinning thiab yog li ntawd tau suav nrog hauv pawg mucolytics. Cov npe ntawm cov tshuaj uas muaj cov khoom xyaw nquag no suav nrog txog ob lub npe ntawm cov tshuaj ntawm ntau hom. Acetylcysteine yog tus cwj pwm los ntawm cov txheej txheem hauv qab no ntawm kev ua:
- Nws muaj nyob rau hauv nws cov molecule reactive sulfhydryl pawg, uas ua puas tsuaj rau cov disulfide tebchaw ntawm mucopolysaccharides, vim hais tias cov hnoos qeev yog yus muaj los ntawm viscosity nce. Yog li ntawd, phlegm thins thiab yooj yim tawm ntawm lub cev.
- Cov tshuaj no pab txo qis kev ua haujlwm thiab txo cov kab mob pathogenic uas nyob rau hauv cov mucous daim nyias nyias ntawm cov kab mob ua pa.
- Nws muaj cov tshuaj antioxidant. Sulfhydryl pawg hnov mob dawb radicals thiab oxygen metabolites thiab tshem tawm ntawm lub cev. Yog li, acetylcysteine muaj cov tshuaj tiv thaiv kab mob thiab tshem tawm lub cev los ntawm cov tshuaj lom neeg, ua rau tus neeg mob zoo heev.
Ntawm cov tshuaj uas muaj acetylcysteine yog cov tshuaj nquag, nws tuaj yeem sau tseg:
- "Mukobene" - ntsiav tshuaj; 100, 200 lossis 600 mg.
- "Mukomist" - tshuaj hauv ampoules, 20% rau kev siv hauv zos thiab nqus pa.
- "Mukoneks" nyob rau hauv daim ntawv ntawm granules, 0.1 g rau ua syrup.
- "Fluimucil" nyob rau hauv daim ntawv ntawm granules, 100 thiab200 mg; ntsiav tshuaj rau fizzy haus, 600 mg.
- "ACC" nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj rau kev npaj ntawm ib tug fizzy haus - 100, 200, 600 mg; kev daws rau kev txhaj tshuaj 300 mg / 3 ml hauv ampoules; granules rau qhov ncauj daws, 100, 200 mg.
- "Acetylcysteine" hauv daim ntawv hmoov, 200 mg; tov rau txhaj tshuaj, 10%; tshuaj rau inhalation, 20%;
- "Acestin" - ntsiav tshuaj rau kev siv sab hauv, 100, 200, 600 mg; effervescent ntsiav tshuaj, 200 thiab 600 mg.
Acetylcysteine thiab kev npaj nrog nws yog contraindicated rau cov menyuam yaus hnub nyoog qis dua 2 xyoos (thiab qee qhov txog li 6 xyoo), cov poj niam cev xeeb tub thiab lactating, cov neeg mob plab hnyuv. Cov kev mob tshwm sim tuaj yeem tshwm sim hauv daim ntawv mob taub hau, stomatitis, tsaug zog thiab tinnitus, mob plab hnyuv, ua xua, thiab tachycardia tsawg dua. Acetylcysteine yuav tsum tsis txhob noj nrog cov tshuaj tiv thaiv kab mob. Nws kuj tseem txhim kho cov nyhuv ntawm nitroglycerin thiab inhibits qhov nqus ntawm cov tshuaj tua kab mob.
YMucolytics nrog Bromhexine
Cov tshuaj muaj cov tshuaj no ua cov khoom xyaw nquag feem ntau yog muab rau hnoos, thiab muab tso rau hauv mucolytics. Cov npe tshuaj yog txwv rau tsib yam khoom siv tshuaj. Ib zaug hauv tib neeg lub cev, Bromhexine ua raws li hauv qab no:
- txo cov viscosity ntawm bronchial secretions los ntawm depolarization ntawm mucus polysaccharides;
- stimulates bronchial mucosal hlwb uas secrete neutral-hom polysaccharides;
- txhawb kev tsim cov surfactant;
- muaj cov nyhuv expectorant;
- slows down the hnoos reflex.
Cov mucolytics teev hauv qab no muaj bromhexine ua cov khoom xyaw tseem ceeb.
Cov no suav nrog:
- "Solvin" - tshuaj rau kev siv sab hauv, 4 mg / 5 ml; ntsiav tshuaj rau qhov ncauj, 8 mg.
- "Bromhexine" hauv daim ntawv ntawm cov tshuaj, 4 mg / 5 ml; yog '4 mg/5 ml; ntsiav tshuaj, 8 mg.
Mucolytic npaj muaj bromhexine yog contraindicated rau cov neeg uas muaj ib tug neeg intolerance rau cov khoom no, nrog rau cov me nyuam hnub nyoog qis dua 6 xyoo. Lawv tuaj yeem ua rau mob plab, mob taub hau, tawm hws ntau ntxiv, ua pob khaus tawv nqaij, thiab bronchospasm. Cov tshuaj Bromhexine tsis tshua muaj tshuaj rau cov poj niam cev xeeb tub thiab lactating.
Npaj nrog carbocysteine
Cov tshuaj no kuj suav nrog hauv pawg Mucolytics. Cov npe ntawm cov tshuaj uas muaj carbocysteine xws li muaj txog kaum yam khoom, tab sis lawv txhua tus muaj cov tshuaj tib yam:
- txo cov ntsiab lus ntawm nruab nrab thiab nce cov kua qaub glycopeptides, normalize lawv feem;
- txo viscosity thiab tswj cov hnoos qeev elasticity;
- regenerate cov pa mucosa thiab rov qab nws cov qauv zoo;
- nce hauv cheeb tsam kuj tseem ceeb lgA;
- normalize kev cais ntawm sulfonyl pawg;
- qhib kev ua haujlwm ntawm ciliated epithelium ntawm bronchi.
Ntau zaus, cov tshuaj mucolytics no tau muab rau cov neeg mob.
Cov npe tshuaj thiab kev npaj muaj carbocysteine yog muab hauv qab no:
- "Libeksin Muko" nyob rau hauv daim ntawv ntawm syrup, 50 mg / ml.
- "Mucodine" hauv daim ntawv tshuaj ntsiav, 125 mg; syrup rau menyuam yaus 125 mg / 5 ml thiab 250 mg / 5 ml.
- "Carbocysteine" hauv daim ntawv syrup 250 mg / 5 ml thiab 125 mg / 5 ml (rau cov menyuam yaus); capsules, 375 mg.
- "Fluifort" nyob rau hauv daim ntawv ntawm granules rau kev ncua, 2.7 mg; syrup, 90 mg/l; syrup 2% (rau cov menyuam yaus) thiab 5%.
Carbocysteine mucolytics, tshuaj thiab kev npaj tau piav qhia saum toj no yuav tsum tsis txhob noj yog tias koj ua xua rau lub ntsiab lus tseem ceeb, nrog rau cov kab mob peptic, ua haujlwm tsis zoo ntawm lub raum, mob glomerulonephritis, cystitis, cev xeeb tub thiab lactation.. Kev npaj nyob rau hauv daim ntawv ntawm capsules yog contraindicated nyob rau hauv cov me nyuam hnub nyoog qis dua 12 xyoo, thiab nyob rau hauv daim ntawv ntawm ib tug phoov - mus txog rau 2 xyoos. Kev npaj hnoos mucolytic raws li carbocysteine tuaj yeem sporulate digestive disorders thiab ua xua tshwm sim.
Tshuaj nrog Ambroxol
Cov tshuaj no yog cov neeg mob nyiam tshaj plaws. Ambroxol muaj cov nyhuv hauv qab no rau tib neeg lub cev:
- txo cov hnoos qeev viscosity thiab adhesion;
- pab kom cov pa paug tawm ntawm txoj hlab pa;
- ua haujlwm ntawm cov hlwb serous ntawm cov qog nqaij hlav ntawm bronchial mucosa;
- txhawb kev tsim cov enzymes uas rhuav tshem cov qauv ntawm cov hnoos qeev polysaccharides;
- txhawb nqa kev tsim tawm surfactant;
- txhawb kev ua haujlwm ntawm bronchial cilia thiab tiv thaiv lawvnyob ua ke.
Vim muaj cov yam ntxwv ua haujlwm no, Ambrocol tau suav nrog hauv pawg Mucolytics.
Cov npe tshuaj uas muaj cov tshuaj no yog qhov dav heev. Nov yog cov tshuaj ambroxol ntau tshaj plaws:
- "Lazolvan" - lozenges, 20 mg; lozenges, 15 mg; daws, 7.5 mg / mL; syrup 15 thiab 30 mg / 5 ml; ntsiav tshuaj, 30 mg.
- "Halixol" - nyob rau hauv daim ntawv ntawm syrup, 30 mg / 10 ml thiab ntsiav tshuaj, 30 mg.
- "Medox" - nyob rau hauv daim ntawv ntawm syrup, 15 mg / 5 ml thiab ntsiav tshuaj, 30 mg.
- "Deflegmin" - hauv daim ntawv tee rau kev tswj qhov ncauj, 0.75% thiab ntsiav tshuaj, 30 mg;
- "Suprima-coff" - nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
- "Mukobron" - nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
- "Drops Bronchovern" - tshuaj rau kev tswj qhov ncauj, 7.5 mg / ml.
- "Ambrobene" - hauv daim ntawv tshuaj ntsiav, 75 mg; kev txhaj tshuaj, 7.5 mg / ml; syrup, 15 mg / 5 ml; ntsiav tshuaj, 30 mg.
- "Ambrohexal" - hauv daim ntawv tshuaj ntsiav, 75 mg; tshuaj rau inhalation thiab kev tswj qhov ncauj, 7.5 mg / ml; syrup 3 thiab 6 mg / ml thiab ntsiav tshuaj, 30 mg.
- "Ambroxol" - nyob rau hauv daim ntawv ntawm syrup, 3 thiab 6 mg / ml; ntsiav tshuaj, 30 mg thiab capsules, 75 mg.
- "Ambrolap" - hauv daim ntawv tshuaj ntsiav, 75 mg; syrup, 15 mg / 5 ml; ntsiav tshuaj, 30 mg; tshuaj rau kev siv sab hauv thiab nqus pa, 7.5 mg / ml.
- "Ambrosan" - nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, 30 mg.
- "Ambrosol" - nyob rau hauv daim ntawv ntawm syrup 0.3 thiab 0.6 g / 100 ml.
- "Remebrox" - nyob rau hauv daim ntawv ntawm syrup 30 mg / 5 ml.
- "Ambrotard 75" - hauv daim ntawv tshuaj ntsiav, 75 mg.
- "Flavamed" - nyob rau hauv daim ntawv ntawm kev daws rau qhov ncauj, 15 mg / 5 ml thiab ntsiav tshuaj,30 mg.
- "Bronchoval" - ntsiav tshuaj, 30 mg; syrup, 15 mg/5 ml.
Nyob ntawm daim ntawv tso tawm ntawm cov tshuaj, muaj contraindications rau noj tshuaj raws li Ambroxol. Xws li kev npaj mucolytic rau cov menyuam yaus hnub nyoog qis dua 2 xyoos yog qhov tsim nyog tsuas yog yog tias qhov ntau npaum ntawm cov tshuaj nquag tsis pub tshaj 3 mg / ml, raws li txoj cai, cov no yog syrups lossis tshuaj. Cov ntsiav tshuaj yuav tsum tsis txhob noj los ntawm cov neeg mob hnub nyoog qis dua 6 xyoo, tshuaj ntsiav - txog 14 xyoo. Tsis tas li ntawd, yog tias tus neeg mob muaj ib tus neeg intolerance rau ambroxol, cov mucolytics tsis tuaj yeem muab tshuaj. Ntawm cov kev mob tshwm sim ntawm cov tshuaj yog kev zom zaub mov, nce kev sib cais ntawm cov hnoos qeev los ntawm lub qhov ntswg, tso zis nyuaj, thiab kev tsis haum tshuaj. Thaum cev xeeb tub, raws li txoj cai, ambroxol tsis raug sau tseg hauv thawj peb lub hlis twg, thiab tom qab ntawd - tsuas yog raws li kev pom zoo ntawm tus kws kho mob.
Mucolytics nrog kev sib xyaw ua ke
Cov tshuaj no muaj ntau yam khoom siv sib txawv uas ua rau cov hnoos qeev nyias nyias, yog li lawv tau suav nrog hauv hom lus "Mucolitics". Nrog hnoos qhuav, cov npe tshuaj uas kws kho mob tau sau tseg los ntawm cov npe tau piav qhia ua ntej hauv kab lus tuaj yeem ntxiv nrog cov tshuaj hauv qab no:
- "Sinupret" - kev kho mob nrog tshuaj ntsuab. Nws muaj gentian hauv paus, primrose thiab elderberry paj, sorrel thiab verbena nyom. Cov tshuaj yog tsim nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj thiab ib tug cawv tov.
- "Rinicold Broncho" yog ib qho tshuaj uas muaj peb lub ntsiab lus tseem ceeb: ambroxol (15 mg), chlorphenamine (2 mg), phenylephrine (5 mg) thiab guaifenesin (100 mg). Raws li qhov tshwm sim ntawm kev noj cov kua dej no, cov viscosity ntawm cov hnoos qeev hauv bronchi txo, expectoration yog yooj yim, lacrimation, khaus ntawm lub qhov muag thiab qhov ntswg raug tshem tawm, o thiab hyperemia ntawm mucous cov ntaub so ntswg ntawm lub pa system txo. Cov tshuaj yog contraindicated nyob rau hauv convulsions, atherosclerosis, kub siab, ntshav qab zib, thyrotoxicosis, pheochromocytoma, kaw-type glaucoma, ulcers, prostate adenoma, qabzib-6-phosphate dehydrogenase deficiency, thaum cev xeeb tub thiab lactation, cov me nyuam hnub nyoog qis dua 6 xyoo, ua xua rau cov khoom. Koj tsis tuaj yeem haus cov kua dej no nrog rau cov tshuaj beta-blockers, tricyclic antidepressants, MAO inhibitors thiab nrog cov tshuaj uas muaj tib yam tshuaj nquag xws li Rinicold Broncho.
Cov complex ntawm cov tshuaj nquag pab txhawb kom muaj txiaj ntsig zoo ntawm cov hnoos qeev los ntawm cov sinuses thiab sab sauv.kab mob ua pa. Ob daim ntawv tshuaj yuav tsum tsis txhob noj los ntawm cov menyuam yaus hnub nyoog qis dua 6 xyoo thiab cov neeg muaj lactase tsis txaus, nrog rau cov neeg uas tsis haum rau cov tshuaj.
Ribonuclease rau hnoos qhuav
Cov mucolytics feem ntau yog kws kho mob tau sau tseg rau hnoos qhuav, cov npe uas tau nthuav tawm ua ntej, tuaj yeem raug ntaus nqi rau cov tshuaj ib txwm siv thiab sijhawm kuaj. Ib txoj hauv kev tshiab thiab niaj hnub no kom tshem tau cov hnoos qeev hauv lub ntsws yog siv ribonuclease lossis dornase alfa. Cov tshuaj no yog cov khoom tsim kho caj ces, ib qho analogue ntawm tib neeg lub cev enzyme, uas yog lub luag haujlwm rau kev tawg ntawm cov cellular DNA.
Yog tias tus neeg mob muaj cystic fibrosis, uas yog tus cwj pwm los ntawm cov txheej txheem sib kis ntau ntxiv, muaj qhov sib txuam ntawm cov kua dej tawm nrog cov viscosity siab. Yog li ntawd, kev ua haujlwm ntawm kev ua pa sab nraud cuam tshuam rau cov neeg mob. Lub purulent zais cia muaj ntau ntawm cov DNA extracellular. Cov khoom no tau tso tawm los ntawm cov leukocytes uas lwj uas tsim los ua cov txheej txheem teb thaum kis kab mob thiab muaj kuab heev. Ribonuclease hydrolytically cleaves hnoos qeev DNA thiab, raws li qhov tshwm sim, mucus liquefies.
Dornase alfa yog ib feem ntawm cov tshuaj "Pulmozim", uas muaj nyob rau hauv daim ntawv ntawm ib tug tov rau inhalation. Cov ntsiab lus ntawm cov tshuaj nquag yog 2.5 mg / 2.5 ml. Cov tshuaj no tau zoo siv hauv cystic fibrosis, nrog rau cov kab mob ntsws ntev: bronchiectasis, COPD, congenital malformations hauv cov menyuam yaus, mob ntsws, kab mob ua pa ntawm lub cev tiv thaiv kab mob.
Pulmozim muaj ob peb contraindications. Cov tshuaj yuav tsum tsis txhob muab rau cov poj niam cev xeeb tub thiab lactating, nrog rau cov menyuam yaus hnub nyoog qis dua 5 xyoos. Cov kev mob tshwm sim hauv kev kho mob ntawm cov tshuaj no tsis tshua muaj thiab tuaj yeem tshwm sim raws li mob lymphocytic leukemia, aplastic anemia, qaug dab peg, migraine, conjunctivitis, imbalance, tachycardia, plawv nres, bradycardia, pneumonia, bronchospasm, digestive disorders, allergic dermatitis, Quinemcke. cev xeeb tub thiab yug me nyuam, mob hauv siab, tsis muaj zog.
Kho raws sijhawm thiab raug
Kab lus no tau teb cov lus nug: "Yuav ua li cas cov tshuaj yog mucolytics?" Daim ntawv teev npe tshaj plawscov tshuaj no muaj npe hu ua.
Nws yog ib qho tsim nyog sau cia hauv txoj hauv kev tshwj xeeb uas daim ntawv xaj ntawm cov tshuaj, nws qhov ntau npaum li cas, nrog rau cov lus pom zoo ntawm lub sijhawm ntawm kev kho mob thiab qhov muaj peev xwm hloov cov tshuaj nrog cov tshuaj analogue yog cov teeb meem uas nyob hauv. lub peev xwm ntawm tsuas yog ib tus kws kho mob tshwj xeeb tom qab kev kuaj mob zoo ntawm tus neeg mob. Kev noj tshuaj rau tus kheej hauv qhov xwm txheej no tuaj yeem tsis tsuas yog ua rau tsis muaj txiaj ntsig, tab sis kuj muaj peev xwm ua rau muaj qhov tshwm sim tsis zoo: los ntawm kev phiv ntawm cov tshuaj mus rau kev txhim kho cov kab mob ntev. Yog li ntawd, yog tias koj muaj cov tsos mob ntawm tus kab mob, tsis txhob ncua mus ntsib kws kho mob. Noj qab nyob zoo!
