Table. 1—

Mucoactive drugs and their potential mechanisms of action

Mucoactive drugsPotential mechanism of action
    Hypertonic salineIncreases secretion volume and/or hydration
    GuaifenesinStimulates secretion and reduces mucus viscosity
    CarbocysteineMetabolism of mucus producing cells, antioxidant and anti-inflammatory effects, modulates mucus production
    Anticholinergic agentsDecreases secretion volume
    GlucocorticoidsReduces airway inflammation and mucin secretion
    Macrolide antibioticsReduces airway inflammation and mucin secretion
    N-AcetylcysteineBreaks disulphide bonds linking mucin polymers
Antioxidant and anti-inflammatory effects
    N-AcystelynIncreases chloride secretion and breaks disulphide bonds
    ErdosteineModulates mucus production and increases mucociliary transport
    Dornase alfaHydrolyses the DNA in mucus and reduces viscosity in the lungs
    GelsolinSevers actin filament cross-links
    Thymosin β4Severs actin filament cross-links
    DextranBreaks hydrogen bonds and increases secretion hydration
    HeparinBreaks both hydrogen and ionic bonds
    BronchodilatorsImproves cough clearance by increasing expiratory flow
    SurfactantsDecreases sputum/mucus adhesiveness
    AmbroxolStimulates surfactant production and inhibits neuronal sodium channels
  • #: also referred to as cough clearance promoters.