Mucolytics: mndandanda wa katundu kwa ana ndi akulu

Pa ARI, zimakhala anakumana ndi zosasangalatsa chodabwitsa amenewa, ngati kutsokomola. Iye ndi yotopetsa ndipo zosasangalatsa, zovuta mpweya ndipo kumachepetsa khalidwe la moyo. Kwa dokotala, ndikofunika kudziwa zotani chifuwa odwala: wouma kapena konyowa. Yoyamba akuti ndi atali-zipatso ndi amakhala ndi vuto expectoration. Chifuwa amatchedwa lokhalamo anthu ndi shortens kuchira wodwalayo. Kupeza mtima mtundu youma chifuwa, madokotala amakonda kulemba mankhwala omwe razzhizhzhayut viscous mucous katulutsidwe, amene aumbike mwa mundawo kupuma. Chifukwa kachulukidwe mkulu wa ntchofu izi wodwalayo amavutika ndi sputum kapena expectoration.

ndi mucolytics chiyani?

Pofuna kuthandiza wodwala ndi chifuwa youma, adokotala zambiri mankhwala mucolytics. Mndandanda wa mankhwala mgulu lino ndi yaikulu kwambiri. Mwa njira ya chikoka pa thupi la munthu mankhwala akhoza kugawidwa m'magulu atatu:

• Mucoregulatory zinthu. Iwo zimakhudza kuchuluka anamasulidwa mucous katulutsidwe. gulu Izi zikuphatikizapo corticosteroids, ndi M-holinoblokatory karbotsistein.
• Mukokinetiki - mankhwala kuti kusintha expectoration a ntchofu. Zikuphatikizapo ambroxol, bromhexine ndi zina zotero.
• Mwachindunji mucolytics. zinthu izi zimathandiza kuti liquefaction wa mucin ndi kuchepetsa kukhuthala ake. Ndi mucolytics monga michere proteolytic, acetylcysteine, ndi zina zotero.

Various njira liquefaction wa sputum

Ngati tikambirana limagwirira imene molekyulu wa mucopolysaccharides asidi ntchofu secretions wa munthu ungathe kuwonongedwa ndi thandizo la mankhwala, misewu yaikulu awiri kungakhale wolemekezeka - ndi njira enzyme ndi njira sanali enzymatic. Mbali yoyamba, ndi michere kuphwanya mapuloteni kulankhulana, ndi zina - disulfide kulumikizana mu mamolekyulu wa sputum.

Gulu la waukulu chigawo yogwira

Zonse mankhwala amaphatikizidwa malinga ndi mayiko gulu la mankhwala ATC pansi malamulo kapena ATS R05CB «Mucolytics". List of zosakaniza yaikulu yogwira amatipatsanso yeniyeni alphanumeric akuti:

• R05CB01 - acetylcysteine.
• R05CB02 - bromhexine.
• R05CB03 - karbotsistein.
• R05CB06 - ambroxol.
• R05CB10 - mankhwala ndi chiphunzitso pamodzi.
• R05CB13 - Dornase alfa (DNase).

Chimene mankhwala, mucolytics perekani kwa wodwala makamaka, zochimwazo kumathetsa dokotala yekha. udindowu anali kuchita pokhapokha bwinobwino, natsogozedwa ndi zotsatira za kufufuza ziwalo. Tiyeni tione mmene aliyense mankhwala yogwira m'gulu mankhwala mu R05CB gulu.

Mucolytics ndi acetylcysteine

Acetylcysteine bwino amathandiza woonda ndi ntchofu, choncho anali mgulu la mucolytics. Mndandanda wa mankhwala ndi mankhwala yogwira zikuphatikizapo za ziwiri khumi zosiyanasiyana mankhwala mitundu. Acetylcysteine amakhala ndi njira kutsatira kanthu:

• Iwo ali mu molekyulu ake zotakasika sulfhydryl gulu chitsanzo, lomwe kanthu pa zowononga mankhwala mucopolysaccharides disulfide chifukwa cha zomwe amakhala ndi kuchuluka ntchofu kukhuthala. Chifukwa cha zimenezi, sputum ndi liquefied ndi excreted m'thupi mosavuta.
• Zinthu zimenezi kumathandiza kuti ntchito kuchepetsa ndi amachepetsa chiwerengero cha tizilombo toyambitsa matenda omwe ali pa mucosa ziwalo kupuma.
• Iwo ali antioxidant katundu. magulu Sulfhydryl anatani ndi ankafuna kusintha zinthu mopitirira ufulu ndi metabolites mpweya ndi kuwachotsa thupi. Choncho, acetylcysteine ali ndi kanthu antiinflammatory ndi thupi ovobozhdaet ku poizoni lomwe easing alili.

Kuyambira kukonzekera munali monga yogwira mankhwala acetylcysteine, akhoza anatchula:

• "Mukobene" - mapiritsi; 100, 200 kapena 600 mg.
• "Mukomist" - yothetsera mu ampoules, 20% kwa apakhungu ndi inhalation.
• "Mukoneks" mu mawonekedwe a pellets, 0,1 ga kuti akonze manyuchi.
• "Fluimucil" mu mawonekedwe a pellets, 100 ndi 200 mg; Mapiritsi kwa fizzy kumwa, 600 mg.
• "ACC" mu maonekedwe a mapiritsi pokonza effervescent chakumwa - 100, 200, 600 mg; jekeseni 300 mg / 3 ml ya mu ampoules; granules njira yothetsera mu 100, 200 mg.
• "Acetylcysteine" mu mawonekedwe ufa, 200 mg; njira jekeseni, 10%; njira yothetsera ngalyatsy, 20%;
• "Atsestin" - Tabuleti kwa makonzedwe mkati, 100, 200, 600 mg; Mapiritsi kwa fizzy kumwa, 200 ndi 600 mg.

Acetylcysteine ndi mankhwala naye contraindicated ana osaposa zaka 2 (ndi ena - mpaka zaka 6 zakubadwa), amayi apakati ndi lactating, anthu ndi m'mimba matenda anam'peza mu gawo pachimake. Mukhoza kuona zotsatira zoyipa monga mutu, stomatitis, ulesi ndi tinnitus, kawirikawiri akuwonetseredwa a m'mimba, chifuwa, tachycardia. Acetylcysteine Simungathe kumwera ndi mankhwala antitussive. Komanso timapitiriza zotsatira za nitroglycerin ndi kumabwezera mmbuyo mayamwidwe wa mankhwala.

Mucolytics ndi bromhexine

Medicaments munali mankhwala monga mbali yogwira zambiri imene kutsokomola, ndi pabwino monga mucolytics. Mndandanda wa mankhwala yochepa mankhwala asanu mankhwala. Kamodzi mu thupi la munthu, bromhexine chimaposa motere:

• Sachita ndi kukhuthala katulutsidwe bronchial ndi ntchofu polysaccharides depolarization;
• Zimathandiza mucosal maselo bronchial amene secrete polysaccharides ndale mtundu;
• Imalimbikitsa mapangidwe surfactant ndi;
• Amalima zotsatira expectorant;
• kumabwezera mmbuyo ndi chifuwa reflex.

Kukonzekera-mucolytics m'munsimu muli ngati waukulu yogwira pophika bromhexine. Njirazi ndi monga:

• "Solvin" - njira yothetsera makonzedwe mkati, 4 mg / 5 ml; mapiritsi ntchito m'kamwa, 8 mg.
• "Bromhexine" mu mawonekedwe a njira, 4 mg / 5 ml; madzi, 4 mg / 5 ml; mapiritsi 8 mg.

Mankhwala, mucolytics, munali bromhexine, ali contraindicated anthu ndi tsankho munthuyo chigawo ichi, komanso ana kwa zaka 6. Angathe kuyambitsa kudzimbidwa, kupweteka kwa mutu, kuchuluka kulekana kwa thukuta, totupa pakhungu ndi bronchospasm. Oyembekezera ndi lactating akazi mankhwala ndi bromhexine yoikidwiratu kawirikawiri.

Mankhwala ndi carbocisteine

Izi mankhwala komanso mgulu la "Mucolytics". Mndandanda wa mankhwala ndi carbocisteine zikuphatikizapo za khumi zinthu, koma zonsezi ndi zofanana kwenikweni mankhwala:

• kuchepetsa zili kuwonjezeka ndale acidic yopanga glycopeptides anawabweretsa ku chiwerengero zawo;
• kuchepetsa kukhuthala ndi kusintha elasticity wa sputum;
• buluzi ndi mucosa wa dongosolo kupuma ndi kubwezeretsa dongosolo mwake;
• kuwonjezera chinthu cha m'dera yeniyeni kukana lgA;
• matenda magulu kusankha sulfigrilnyh;
• anawonjezera ntchito ya ciliated bronchial epithelium.

Nthawi zambiri, odwala amapatsidwa mucolytics zoterezi. A mndandanda wa mankhwala ndi kukonzekera munali karbotsistein wapatsidwa pansipa:

• "Libeksin Muko" mu mawonekedwe a madzi, 50 mg / ml.
• "Mucodyne" mu mawonekedwe a makapisozi, 125 mg; manyuchi ana 125 mg / 5 ml mpaka 250 mg / 5 ml.
• "Karbotsistein" manyuchi 250 mg / 5 ml ndi 125 mg / 5 ml (ana); Makapisozi, 375 mg.
• "Fluifort" mu mawonekedwe a granules kwa kuyimitsidwa, 2,7 mg wa; Syrup, 90 mg / L; manyuchi 2% (ana) ndi 5%.

Karbotsisteinovye mucolytics, mankhwala ndi mankhwala omwe tafotokozazi akhoza kumwedwa ndi mfundo wakukhala ndi ziwengo kuti mbali yaikulu komanso matenda chironda chachikulu, zipolowe za funktsionirovaniyapochek wabwinobwino, glomerulonephritis mu pachimake mawonekedwe, cystitis, mimba ndi yoyamwitsa. Kukonzekera mu mawonekedwe a makapisozi ndi contraindicated kwa ana osaposera zaka 12, ndipo mu mawonekedwe a madzi - zaka 2. Mankhwala, mucolytics chifuwa zochokera karbotsisteina akhoza sporovotsirovat rastrojstva chimbudzi ndi matupi awo sagwirizana mawonetseredwe.

Mankhwala ndi ambroxol

Mankhwalawa ndi otchuka pakati pa anthu odwala. Ambroxol ali zotsatira izi pa thupi la munthu;

• Iwo amachepetsa kukhuthala index ndi guluu wolimba wa sputum;
• facilitates kumaliseche a ntchofu kwa Airways;
• imayendetsa maselo serous wa mucosa bronchial a minofu glandular;
• Zimathandiza yopanga michere kuti amanyoza Kapangidwe ka polysaccharides wa sputum;
• kulimbikitsa ulimi wa surfactant;
• Zimathandiza ndi cilia wa bronchi ndi zimawalepheretsa kusagwirizana.

Chifukwa zochita za mfundozi ambrokola linaphatikizidwa gulu "Mucolytics". A mndandanda wa mankhwala okhala chigawo ichi ndi yaikulu. Pano pali mankhwala ambiri ndi ambroxol:

• "Mucosolvan" - lozenges, 20 mg wa; pastilles 15 mg; njira, 7.5 mg / ml ya; manyuchi 15 ndi 30 mg / 5 ml; mapiritsi, 30 mg.
• "Haliksol" - mu mawonekedwe a madzi ndi, 30 mg / ml ya ndi miyala 10, 30 mg.
• "Maddox" - mu mawonekedwe a madzi ndi, 15 mg / 5 ml ndi miyala, 30 mg.
• "Deflegmin" - mu mawonekedwe a madontho kwa makonzedwe m'kamwa, miyala ndi 0,75%, 30 mg wa;
• "Suprema-COF" - mu mawonekedwe a mapiritsi, 30 mg.
• "Mukobron" mawonekedwe -kuti miyala, 30 mg.
• "Madontho Bronhovern" - njira yothetsera makonzedwe mkati, 7.5 mg / ml.
• "Ambrobene" - mu mawonekedwe a makapisozi, 75 mg; njira jekeseni, 7.5 mg / ml ya; manyuchi, 15 mg / 5 ml; mapiritsi, 30 mg.
• "Ambrogeksal" - mu mawonekedwe a makapisozi, 75 mg; njira yothetsera inhalation ndi ingestion, 7.5 mg / ml ya; manyuchi 3 ndi 6 mg / ml ya ndi miyala, 30 mg.
• "Ambroxol" - mu mawonekedwe a madzi ndi 3 6 mg / ml ya; mapiritsi, makapisozi, 30 mg wa ndi 75 mg.
• "Ambrolap" - mu mawonekedwe a makapisozi, 75 mg; manyuchi, 15 mg / 5 ml; mapiritsi, 30 mg wa; rastvoa kwa phwando m'nyumba ndi inhalation, 7.5 mg / ml.
• "Ambrosan" - mu mawonekedwe a mapiritsi, 30 mg.
• "Ambrosol" - ngati madzi 0,3 ndi 0,6 g / 100 ml.
• "Remebroks" -kuti kupanga manyuchi 30 mg / 5 ml.
• "Ambrotard 75" mawonekedwe, pantchito ya kapisozi, 75 mg.
• "Flavamed" - mu mawonekedwe a njira yothetsera makonzedwe m'kamwa, 15 mg / 5 ml ndi miyala, 30 mg.
• "Bronhoval" - mapiritsi, 30 mg wa; Syrup, 15 mg / 5 ml.

Malinga mawonekedwe za kumasulidwa kwa mankhwala, pali contraindications ku phwando pa maziko a mankhwala ambroxol. zinthuzi, mucolytics kwa ana ochepera zaka 2 abwino pokhapokha ngati mlingo wa mankhwala yogwira si upambana 3 mg / ml, kawirikawiri madzi kapena njira. Miyalayo Simungathe kumwera kwa odwala pansi zaka 6, kapisozi - kwa zaka 14. Komanso, ngati wodwala ndinu hypersensitive kuti ambroxol, deta mucolytics sangathe anapatsidwa. Mwa mavuto a mankhwala - kudzimbidwa, kuchuluka kulekana ndi mamina m'mphuno, vuto kukodza, matupi awo sagwirizana zochita. Pamene mimba nthawi ambroksol sanagaŵiridwe mu trimester, ndi zapambuyo pake - yekha malangizo dokotala.

Mucolytics ophatikizana zikuchokera

medicaments zimenezi zimakhala zinthu zosiyanasiyana kuphunzira kanthu, yomwe liquefaction wa sputum, kotero iwo anali nawo mu kufanizitsa "Mucolytics". Pamene youma chifuwa mndandanda wa mankhwala zotchulidwa dokotala ku mndandanda kale anafotokoza m'nkhani ino, akhoza wodzilemekeza ndi mankhwala zotsatirazi:

• "Sinupret" - zikutanthauza zigawo chomera. Lili gawo la muzu gentian, maluwa Primrose ndi elderberry therere chotchezera ndi vervain. lokonzekera analengedwa mu mawonekedwe a mapiritsi kapena njira mowa. yogwira zovuta facilitates kumaliseche nchito ya ntchofu ku m'njira za m'mphuno ndi kapepala chapamwamba kupuma. formulations awiri sangathe kutenga ana mpaka zaka 6 zakubadwa ndi anthu akusowa lactase, komanso pamaso pa ziwengo mankhwala zigawo zikuluzikulu.
• "Rinikold Broncho" - kukonzekera zimene yophatikiza zigawo zikuluzikulu zitatu: ambroxol (15 mg), chlorphenamine (2 mg), phenylephrine (5 mg) ndi guaifenesin (100 mg). Chifukwa cha alandira madzi kukhuthala amachepetsa ntchofu mu bronchi, ndi kosavuta expectoration, kumatha womwetula, kuyabwa cha maso ndi mphuno, amachepetsa kutupa ndi redness a minofu mucous a dongosolo kupuma. mankhwala ali contraindicated mu spasms, atherosclerosis, matenda oopsa, shuga, hyperthyroidism, pheochromocytoma, khungu, anatseka-mtundu, chapamimba, Prostate adenoma, akusowa shuga-6-mankwala dehydrogenase, mimba ndi mkaka wa m'mawere, ana akale pansi 6 zaka matupi awo sagwirizana ndi zigawo zikuluzikulu. Inu Simungathe kumwera madzi ndi betaadrenoblokatorami, tricyclic antidepressants mitundu, Mao zoletsa ndi mankhwala okhala yemweyo yogwira mankhwala monga "Broncho Rinikold".

Ribonuclease zochizira akutsokomola youma

Kawirikawiri zotchulidwa madokotala mucolytics ndi chifuwa youma, mndandanda wa zomwe zinakambidwa kale, akhoza zimachitika mankhwala chikhalidwe ndi kuyesedwa ndi nthawi. Yatsopano ndi zamakono njira ndiyotani pakuchotsa ntchofu viscous mu kapepala kupuma - kugwiritsa ntchito ribonuclease kapena dornase alfa. mankhwala ndi mankhwala osiyana adapanga, ndi analogue a enzyme zachilengedwe anthu amene ali ndi udindo pogawanikana pamawere ya DNA extracellular.

Pamaso pa enaake fibrosis wodwalayo, amene amakhala ndi chidwi opatsirana ndondomeko, kudzikundikira purulent secretions ndi kukhuthala mkulu. Chifukwa, odwala chakhungu ntchito kupuma. Mu purulent secretions lalikulu zedi lili DNA extracellular. particles awa kumasulidwa ku leukocytes kuvunda opangidwa ngati limagwirira yankho ku matenda ndipo ndi kukhuthala mkulu. Ribonuclease cleaves DNA hydrolytic ndi phlegm ndi mamina chifukwa liquefied.

Dornase alfa ndi mbali ya "Pulmozyme" mankhwala, amene amapangidwa mu mawonekedwe a njira yothetsera inhalation. Yogwira nkhani okhutira - 2.5 mg / 2.5 ml. Izi mankhwala wakhala bwinobwino ntchito ndi enaake fibrosis ndi aakulu obstructive matenda m'mapapo mwanga: matenda bronchiectasis, COPD, malformations kobadwa nako ana, chibayo, zotupa kupuma immunodifitsitnogo khalidwe.

Contraindications "Pulmozim" pokha. mankhwala sayenera Kwalamulidwa kwa akazi apakati ndi lactating ndi ana osaposa zaka 5. Zotsatira zake zoyipa mu mankhwala chida n'zochepa ndi angagwe ngati lymphocytic khansa pachimake mawonekedwe a magazi m'thupi aplastic, khunyu, migraine, conjunctivitis, disequilibrium, tachycardia, kumangidwa mtima, bradycardia, chibayo, bronchospasm, matenda m'mimba, matupi awo sagwirizana dermatitis, angioneurotic edema, matenda pakati komanso pobereka, kupweteka m'chifuwa, kufooka.

Ankachitira mwamsanga ndi moyenera

Nkhaniyi kuwunikira funso lakuti: "Kodi mankhwala - mucolytics?" Mndandanda wa mankhwala ambiri ya gulu dzina lake. Kuyenera mwapadera ananena kuti kugwiritsa ntchito mankhwala, mlingo wake, komanso malangizo nthawi ya njira ya mankhwala ndi kuthekera kuchotsa mankhwala analogue - nkhani zimene ndi udindo wa dokotala pambuyo pa matenda mokwanira wodwala. Self-mankhwala imeneyi kungakhale osati zobweza, komanso amatha kuyambitsa zotsatira sizimadziwika ku mavuto a mankhwala chitukuko cha matenda aakulu. Choncho, pamaso pa zizindikiro matenda musazengereze kudzacheza kwa dokotala. Khalani wathanzi!