I-Mucolytics: uludwe lwamachiza kubantwana nakubantu abadala

Kwiimeko eziphambili zokuphefumula, sisoloko sibhekana nesiganeko esinzima njengoko kukhwehlela. Kunzima kwaye kunzima, kwenza ukuphefumula kunzima kwaye kunciphise kakhulu umgangatho wobomi. Kubaluleke kakhulu ukuba ugqirha afune ukuba yeyiphi uhlobo lokukhwehlela kwesigulane: unomile okanye umanzi. Uhlobo lo kuqala lubhekwa lukhuni kwaye lubonakaliswe ubunzima bokutshiza. Ukukhwehlela okumanzi kuthiwa kuvelisa kwaye kuphelisa ixesha lokubuyisela isigulane. Emva kokufumanisa uhlobo olomileyo lokukhwehlela kwisigulane, oogqirha bahlala banika izidakamizwa ezixhamla imfihlelo ye-viscous mucous eyenziwa kwiindawo zokuphefumula. Ngenxa yokunyuka kobuninzi balo mkhuhlane, isigulane sinokujamelana nobunzima ngokukhutshwa kwe-sputum okanye ukuxothwa.

Ziziphi i-mucolytics?

Ukuze uncede isigulane esinomkhuhlane owomileyo, ugqirha uhlala echaza i-mucolytics. Uluhlu lwezilwanyana ezibandakanya kweli qela likhulu kakhulu. Ngokuya kwindlela yokuchaphazela emzimbeni womntu, la mayeza anokwahlukana ngamaqela amathathu:

• Ukucoca izinto. Zichaphazela umthamo we-secretion eyimfihlo. Eli qela liquka i-glucocorticosteroids, i-M-holinoblokatory kunye ne-carbocysteine.
• I-Mukokinetics ziyizidakamizwa eziphucula kakhulu ukuphunyuka kwe-mucus. Ezi ziquka i-ambroxol, i-bromhexine, njl.
• I-mucolytics ngqo. Ezi zinto zifaka isandla ekunyameni kwe-secretion ye-mucous ngokunciphisa i-viscosity yayo. I-Mucolytics iquka i-proteolytic enzymes, i-acetylcysteine, njl.

Iinkqubo ezahlukeneyo zokuxhamla i-sputum

Ukuba sicinga indlela apho i-molecule ye-acid mucopolysaccharides ye-mucosal secretion yomntu inokutshabalaliswa ngoncedo lwamalungiselelo, iindlela ezimbini eziphambili ziyakwazi ukubonakaliswa: indlela ye-enzyme kunye ne-non-enzymatic pathway. Kwimeko yokuqala, ii-enzyme zonakalisa izibophelelo zeeprotheni, kwaye kwenye, iibhulorho ze-disulfide kuma-molecule ase-sputum.

Ukwahlulelwa ngumxube osebenzayo

Zonke ezi zilungiselelwe zidibene ngokuhambelana ngamazwe ngamazwe ATX okanye i-ATS phantsi kwekhodi R05CB "Mucolytics". Uluhlu lwezinto ezisemgangathweni zibonelela ngolwazi oluthile lweelfabhethi nolwazi:

• R05CB01 yi-acetylcysteine.
• R05CB02 i-bromohexine.
• R05CB03 yi-carbocysteine.
• R05CB06 yi-ambroxol.
• R05CB10 - amalungiselelo ngokubunjwa okudibeneyo.
• R05CB13 - iDornase alfa (deoxyribonuclease).

Ugqirha kuphela oya kuthatha isigqibo sokuba yiyiphi i-mucolytics yokumisela isigulane esithile isigqirha. Olu qeshwaniso, wenza kuphela emva kokuvavanywa ngokupheleleyo kwaye ukhokelwa ziziphumo zohlalutyo olufanelekileyo. Masiqwalasele ngokuthe ngqo ukuba i-substance nganye esebenzayo ebandakanywa ngamachiza kwi-R05CB iqela isebenza.

Mucolytics nge-acetylcysteine

I-Acetylcysteine iyanceda ngokukhawuleza i-phlegm, kwaye ngoko ke yayifakwe kwiqela le-mucolytics. Uludwe lwamalungiselelo nale nkunkuma esebenzayo lubandakanya ngamagama amabini amabini amayeza eendlela ezahlukeneyo. I-Acetylcysteine ibonakaliswe ngolu hlobo lwezenzo:

• Iqulethwe ngamaqela e-sulfhydryl ayo asebenzayo, asebenza ngokukhawuleza kwiimveliso ze-discopide ze-mucopolysaccharides, ngenxa yokuba i-mucus ibonakala ngokunyuka kwe-viscosity. Ngenxa yoko, i-sputum ihlanjululwe kwaye ikhutshwe emzimbeni ngokulula.
• Le nkunkuma iyanciphisa umsebenzi kwaye iyanciphisa inani lezilwanyana eziphilayo ezikhoyo kwi-mucosa yamalungu okuphefumula.
• Unayo impahla ye-antioxidant. Amaqela e-Sulfhydryl asabela ngama-radical ezamahala kunye ne-oxygen metabolites kwaye awakhuphe emzimbeni. Ngaloo ndlela, i-acetylcysteine inefuthe elichasayo kunye nokukhupha umzimba kwizinto eziyingozi, ukulungiselela kakhulu imeko yesigulane.

Ukususela kumalungiselelo aqukethe njenge-active acetylcysteine, kunokwenzeka ukuba uqaphele:

• "Umkobene" - amaphilisi; 100, 200 okanye 600 mg.
• "Umkomist" - isisombululo kwi-ampoules, i-20% yesicelo sezobugcisa kunye nokuphuza.
• "Mukonex" ngendlela ye-granules, 0.1 g yokulungiselela isiraphu.
• "I-Fluimucil" ngendlela ye-granules, i-100 kunye ne-200 mg; Iibhulethi zokufumana isiphuzo sokuphuza, 600 mg.
• "IMITHETHO" kwindlela yamacwecwe okulungiselela isiselo esinomlilo - 100, 200, 600 mg; Ukungena kwe-300 mg / 3 ml kwi-ampoules; Granules ukufumana isisombululo ngaphakathi, 100, 200 mg.
• "Acetylcysteine" kwifom powder, 200 mg; Isisombululo sejoza, 10%; Isisombululo sokuphunyezwa kwemida, i-20%;
• "I-Acetin" - iipilisi zokulawulwa kwangaphakathi, i-100, 200, 600 mg; Iipilisi zokufumana isiphuzo esiphucukileyo, 200 kunye no-600 mg.

I-Acetylcysteine kunye neziyobisi kunye nazo ziphikisana nabantwana abangaphantsi kweminyaka emi-2 (kunye neminyaka engama-6), abafazi abakhulelweyo nabaqhawulayo, abantu abanezifo zesilonda esiswini. Kukho iziphumo ezinobungozi kwimeko yesifo sekhanda, i-stomatitis, ukuzelazela kunye nesandi ezindlebeni, kukho ukungaxakeki kancinci kwe-GI, i-allergies, i-tachycardia. I-Acetylcysteine ayikwazi ukunxila kunye neziyobisi ezichasayo. Kwakhona kuphucula umphumo we nitroglycerin kwaye inqanda ukutshatyalaliswa kwee-antibiotics.

Mucolytics nge bromhexine

Izidakamizwa eziqulethwe ngolu hlobo njengesithako esisebenzayo zivame ukumiselwa ukukhwehlela, kwaye zibekwe njenge-mucolytics. Uluhlu lwamachiza lugqityiweyo kwimveliso emihlanu yeyeza. Ukungena emzimbeni womntu, i-bromheksin yenza kanje:

• Iyanciphisa i-viscosity ye-secontions eyimibhobho ngokudlulela kwi-mucus polysaccharides;
• Ikhuthaze iiseli ze-bronchial mucosa, ezenza i-polysaccharides ye-secret;
• Ukukhuthaza ukubunjwa koqhagamshelwano;
• Uvelisa umphumo we-expectorant;
• Iyakuthintela ukukhwehlela.

I-Mucolytics, echazwe ngezantsi, iqulethe i-bromhexine njengesithako esisebenzayo. Ezi ziquka:

• Isisombululo sangaphakathi sikaSolvyn, 4 mg / 5 ml; Iipilisi zokusetyenziswa komlomo, 8 mg.
• "Bromhexine" ngesimo sesisombululo, 4 mg / 5 ml; Isiraphu, 4 mg / 5 ml; Iibhodi, 8 mg.

Izidakamizwa zeMucolytic eziqulethe i-bromhexine zichazwe ngabantu abangenakubekezelelana kweli candelo, kunye nabantwana abaneminyaka engama-6 ubudala. Zingabangela ukunyanzeliswa, intloko, ukunyuka okukhulu, ukugqithisa kwesikhumba kunye ne-bronchospasm. Abafazi abakhulelweyo nabaqhawulayo abanqabile ukuba bafumane imishanguzo ne-bromhexine.

Ukulungiselela nge carbocysteine

Esi sidakamizwa sifakwe kwiqela leMucolytics. Uluhlu lwezilwanyana kunye ne-carbocysteine luquka amagama angama-10, kodwa zonke zinomphumo ofanayo wezobisi:

• Ukunciphisa umxholo wokungathathi hlangothi kunye nokwandisa umveliso we-acly glycopeptides, ulungelelanise inani lawo;
• Ukunciphisa i-viscosity kwaye ulawule ukunyuka kwe-sputum;
• Ukuhlaziywa kwakhona kwiimbumba ezinobuncu beendawo zokuphefumula kwaye ubuyisele isakhiwo sayo esivamile;
• Ukwandisa inkcazo ethile yendawo yenkcaso lgA;
• Ukulungelelanisa ukwahlukana kwamaqela e-sulfhydryl;
• Iququzelela umsebenzi we-citheary epithelium ye-bronchi.

Ngokuqhelekileyo, izigulane zichazwe njenge-mucolytics. Uluhlu lwamachiza kunye namalungiselelo aqukethe i-carbocysteine lunikezelwa ngezantsi:

• "Libexin Muko" ngesimo sesiraphu, 50 mg / ml.
• "I-Mucodin" ngefomsi, 125 mg; Isiraphu kubantwana abangama 125 mg / 5 ml kunye ne 250 mg / 5 ml.
• "Carbocysteine" ngesimo sesiraphu 250 mg / 5 ml kunye ne 125 mg / 5 ml (kubantwana); Iipsulules, 375 mg.
• "Fluviert" ngendlela yegranules ukufumana ukumiswa, 2.7 mg; Isiraphu, 90 mg / l; Isiraphu 2% (kubantwana) kunye no-5%.

I-Carbocysteine mucolytics, iziyobisi kunye namalungiselelo achazwe apha ngasentla akunakuthathwa xa kwenzeka i-allergies ukuya kwicandelo eliphambili, kunye nezilonda, ukusebenza ngokungaqhelekanga kwesibindi, i-glomerulonephritis kwifomu echanekileyo, i-cystitis, ukukhulelwa kunye ne-lactation. Ukulungiselela ngendlela yeefomsile zichasene kubantwana abangaphantsi kweminyaka eyi-12, kwaye ngohlobo lwesiraphu - ukuya kwiminyaka emi-2. Izidakamizwa zeMucolytic kwi-khofu ezisekelwe kwi-carbocysteine zingabangela ukuphazamiseka kokugaya kunye nokubonakaliswa kwemvelo.

Amachiza kunye ne-ambroxol

Ezi zi yobisi zithandwa kakhulu kwizigulane. U-Ambroxol unempembelelo elandelayo kumzimba womntu:

• Iyanciphisa i-viscosity kunye nokunamathela kwe-sputum;
• Iququzelela ukusinda kwesikhusela kwindlela yokuphefumula;
• Iququzelela umsebenzi weeseli ze-serous zezicubu zengqungquthela ye-mucosa ye-bronchial;
• Ikhuthaza ukuveliswa kwee-enzymes ezonakalisa isakhiwo se-polysaccharides ye-sputum;
• Ukukhuthaza ngokuphangaleleyo iimveliso ezinxulumene nomsebenzi;
• Ikhuthaze umsebenzi we-cilia ye-bronchi kwaye ibathintele ukuba banamathele ndawonye.

Ngenxa yokufumaneka kwezi zinto, i-Ambrokol ifakiwe kwiqela elithi "Mucolytics". Uluhlu lwezilwanyana eziqulethe eli candelo likhulu kakhulu. Nazi izidakamizwa eziqhelekileyo ezine-ambroxol:

• "Lazolvan" - iipilisi zokubuyisela, i-20 mg; Pastilles, 15 mg; Isixazululo, 7.5 mg / ml; Isiraphu 15 no-30 mg / 5 ml; Iipilisi, 30 mg.
• "Khaliksol" - ngendlela yesiraphu, i-30 mg / 10 ml kunye namacwecwe, 30 mg.
• "Medox" - ngendlela yesiraphu, i-15 mg / 5 ml kunye namacwecwe, 30 mg.
• "I-Deplogmine" - ngohlobo lwamaconsi olawulo lomlomo, i-0.75% kunye namacwecwe, 30 mg;
• "Suprima-kof" - ngendlela yamacwecwe, 30 mg.
• "Mukobron" ngendlela yamacwecwe, 30 mg.
• "I-brronchovern drops" isisombululo sokulawulwa kwangaphakathi, 7.5 mg / ml.
• "I-Ambrogen" - ngendlela yeefomsile, 75 mg; Isisombululo somjovo, 7.5 mg / ml; Isiraphu, 15 mg / 5 ml; Iipilisi, 30 mg.
• "Ambrohexal" - ngendlela yeefomsile, 75 mg; Isixazululo sokunyuselwa kunye nokungena, 7.5 mg / ml; Isiraphu 3 no-6 mg / ml kunye namacwecwe, 30 mg.
• "I-Ambroxol" - ngendlela yesiraphu, 3 kunye no-6 mg / ml; Iipilisi, i-30 mg kunye neesekhsile, 75 mg.
• "I-Ambrolap" - ngeefomsile, 75 mg; Isiraphu, 15 mg / 5 ml; Iipilisi, 30 mg; Isixazululo sokulawulwa kwangaphakathi kunye nokufuthwa, 7.5 mg / ml.
• "I-Ambrosan" - ngendlela yamacwecwe, 30 mg.
• "I-Ambrosol" - ngendlela yesiraphu 0,3 no-0,6 g / 100 ml.
• "Remebroks" ngesimo sesiraphu se-30 mg / 5 ml.
• "I-Ambrotard 75" -kuhlobo lwee-capsules, 75 mg.
• "I-Flavamed" - ngendlela yesisombululo sokulawulwa komlomo, 15 mg / 5 ml kunye namacwecwe, 30 mg.
• "Bronchoval" - amaphilisi, 30 mg; Isiraphu, 15 mg / 5 ml.

Ngokuxhomekeke kwindlela yokukhutshwa kweziyobisi, kukho ukuchasene nokuthatha imishanguzo ngesiseko se-ambroxol. I-mucolytics enjalo kubantwana abaneminyaka engaphantsi kwe-2 iya kusebenza kuphela ukuba i-dosage ye-substance esebenzayo ayidluli kwi-3 mg / ml, ngokuqhelekileyo isiraphu okanye isisombululo. Iibhilethi azikwazi ukunxila kwizigulana ezingaphantsi kweminyaka engama-6, iifomsules - ukuya kwiminyaka eyi-14. Kwakhona, ukuba isigulane sinokuxhaswa komntu kwi-ambroxol, ezi zi-mucolytics azikwazi ukumiselwa. Phakathi kwemiphumo emibi yeziyobisi - ukuphazamiseka kokugaya, ukunyuka kwe-mucus kwipumlo, ubunzima bokuvuthwa, ukuphendulwa komzimba. Xa ukhulelwe, njengomyalo, i-ambroxol ayinqunywanga kwi-trimester yokuqala, kwaye kwimiqathango kamva - kuphela kwiingcebiso zogqirha.

I-Mucolytics enezinto ezidibeneyo

La mayeza anezinto ezininzi ezisebenzayo ezahlukileyo kumsebenzi wazo, eziqinisekisa ukunyuka kwe-phlegm, ngoko ke zifakiwe kwi-typology ye "Mucolytics". Ngomkhuhlane owomileyo, uluhlu lwezilwanyana ezichazwe ngugqirha ovela kwoluhlu oluchazwe ekuqaleni kwinqaku lungancediswa ngamachiza alandelayo:

• "Sinupret" yindlela yokulungisa izityalo. Iqule kwingcambu ye-gentian, iintyatyambo ze-primrose kunye nomdala, utshwala obushushu kunye ne-verbena. Isilwayo sisesimo seepilisi kunye nesisombululo sotywala. Ubunzima bezinto ezisebenzayo kubangela ukuba ususwe ngokufanelekileyo kwe-muscus kwizono zangasese kunye nephepha eliphezulu lokuphefumula. Zomabini iifom zeesayithi akufanele zithathwe kwabantwana abangaphantsi kweminyaka engama-6 ubudala kunye nabantu abane-lactase, kwaye ukuba kukho ukungabikho komzimba kumacandelo eyeza.
• I-Rinicold Broncho isilwanyana esinezixhobo ezintathu ezisisiseko: i-ambroxol (15 mg), i-chlorphenamine (2 mg), i-phenylephrine (5 mg) kunye ne-guaifenesin (100 mg). Njengomphumo wokuthatha isiraphu, i- sputum viscosity kwi-bronchi iyancipha , i- expectoration iyancitshiswa, ukugqabhuka kupheliswa, ukuvakala kwamehlo kwimeko kunye neempumlo kubonakala, i-edema kunye ne-hyperemia yezicubu ezinamaqabunga ezinkqubo zokuphefumula ziyahla. Isilwanyana siyaphikisana kwiimeko zokuxinwa, i-atherosclerosis, i-hypertension, isifo sikashukela, i-thyrotoxicosis, i-pheochromocytoma, i-glaucoma yohlobo oluvaliweyo, isilonda, i-prostate adenoma, i-glucose-6-phosphate dehydrogenase engenakwanela, ukukhulelwa kunye nexesha lokulahlwa, abantwana abangaphantsi kweminyaka engama-6 ubudala, ukungabikho kwamandla kwizinto. Awukwazi ukusela esi siviki nge-beta-adrenoblockers, i-tricyclic antidepressants, i- MAO inhibitors kunye neziyobisi ezinezinto ezifanayo ezisebenzayo njengoRicicold Broncho.

I-Ribonuclease ukwenzela unyango lwekhwehlela elomileyo

I-Mucolytics idla ngokugqithiswa ngabagqirha abanomkhuhlane owomileyo, uluhlu lwabhengezwa ngaphambili, lunokuthi lubangelwe kwiziyobisi ngexesha eliqhelekileyo kunye novavanyo. Indlela entsha kunye neyamanje yokuphelisa i-sputum e-viscous kwizitho zokuphefumula kukusetyenziswa kwe-ribonuclease okanye i-dornase i-alpha. Le nkunkuma ngumkhiqizo oveliswa ngokwemizimba, umzobo we-enzyme yomntu, ojongene nokucocwa kwe-DNA ye-extracellular.

Ekubeni kwesigulane nge-cystic fibrosis, esichazwa yinkqubo echaphazelayo, ukuhlanganiswa kwe-secretion ye-purulity ne-viscosity ephezulu ibonwa. Ngenxa yoko, umsebenzi wokuphefumula kwangaphandle uphazamiseka kwizigulane. Kwimfihlo yecala, i-DNA eyongezelelweyo i-DNA iqulethe. Ezi ngqungquthela zikhutshwa kwi-leukocytes ehlahlayo, yenziwe njengendlela yokuphendula isifo, kwaye ine-viscosity ephezulu. I-Ribonuclease i-hydrolytically ikhiphe i-DNA ye-sputum kwaye, ngenxa yoko, i-mucus iyancipha.

I-Dornase i-alpha yinxalenye yokulungiselela "iPulmozim", efumaneka kwiindlela zesisombululo sokufumba. Isiqulatho sezinto ezisetyenziswayo si-2.5 mg / 2.5 ml. Esi sidakamizwa sisetyenziswe ngempumelelo kwi-cystic fibrosis, kunye nezifo ezingapheliyo zamaphaphu: izifo ze-bronchiectatic, i-COPD, ukukhubazeka komntwana kubantwana, isifo se-pneumonia, umonakalo wokuphefumula we-immunodeficiency.

I-Pulmozym inezinto ezimbalwa ezingqinelanayo. Isilwanyana akufanele sinikezelwe kwabasetyhini abakhulelweyo nabasetyhini, okanye abantwana abangaphantsi kweminyaka emi-5 ubudala. Imiphumo emibi yale mveliso ayinqabile kwaye ingabonakalisa njenge-lymphatic acute leukemia, i-anemia ye-anemia, i-stpile, i-migraine, i-conjunctivitis, i-disequilibrium, i-tachycardia, ukuboshwa kwentliziyo, i-bradycardia, i-pneumonia, i-bronchospasm, ukuphazamiseka kokutya, i-dermatitis, i-edema, i-disema Ukukhulelwa nokunikezelwa, intlungu yesifuba, ubuthathaka.

Ukuphathwa ngokukhawuleza nangokuchanekileyo

Kule nqaku umbuzo uthathelwe ingqalelo: "Ziziphi iilungiselelo ze-mucolytics?" Uluhlu lwezilwanyana eziqhelekileyo zeli qela luthiwa igama. Kufuneka kuqatshelwa ngokukodwa ukuba injongo yesilwayo, umyinge wayo, kunye neengcebiso malunga nobude bexesha lokunyanga kunye nokuba kunokwenzeka ukutshintshwa kwesilwanyana ngesifananiselo nemiba enokukwazi ukufumana ingcali yonyango kuphela emva kokuxilongwa ngokucacileyo kwesigulane. Ukuzinyango kule meko kungekhona nje ukuvelisa, kodwa kunokukhokelela kwimiphumo engalindelekanga: kwimiphumo emibi yezidakamizwa ekuphuhlisweni kwezifo ezingapheliyo. Ngoko ke, ukuba unempawu zokugula, ungalibali ukutyelela ugqirha. Yimpilo!