Ambroksol – więcej niż mukolityk. Powody, dla których warto stosować lek mukoaktywny Artykuł przeglądowy
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Opublikowane:
mar 31, 2024
Słowa kluczowe:
mukolityki, mukokinetyki, ambroksol, POChP
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Abstrakt
Leki mukolityczne i ich działanie to źródło rozmaitych wątpliwości zarówno pacjentów, jak i lekarzy. Część z nas sądzi, że są one bardzo ważne w leczeniu wielu chorób, niektórzy zaś podchodzą sceptycznie do ich celowości i możliwości zastosowania. Według niektórych mogą one prowadzić do nadmiernej produkcji wydzieliny, a inni uważają taki mechanizm mukolityku za zasadny. W niektórych chorobach nie podaje się ich wcale, w innych zaś – stosowane są z pełnym przekonaniem przez wielu specjalistów. Mimo to nie zawsze są podawane zgodnie z wytycznymi lub badaniami klinicznymi. Niniejsza krótka praca przeglądowa jest próbą wyjścia naprzeciw tym wątpliwościom i omówieniem zastosowania leku mukoaktywnego o wielokierunkowym działaniu – ambroksolu.
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Jak cytować
Pawliczak, R. (2024). Ambroksol – więcej niż mukolityk. Powody, dla których warto stosować lek mukoaktywny. Medycyna Faktów , 17(1(62), 77-81. https://doi.org/10.24292/01.MF.0124.12
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Bibliografia
1. Romano C, Gargani GF, Minicucci L et al. Controlled clinical study on the activity of a new mucoregulating drug in obstructive bronchial pathology with a marked hypersecretory feature. Paediatric experience. Min Ped. 1984; 36(3): 127-38.
2. Michnar M, Milanowski J. Ocena kliniczna skuteczności i tolerancji doustnego leczenia ambrosolem u chorych na przewlekłe zapalenie oskrzeli. 7Pneumonol Alergol Pol. 1996; 64(suppl 1): 90-6.
3. Paleari D, Rossi GA, Nicolini G et al. Ambroxol: a multifaceted molecule with additional therapeutic potentials in respiratory disorders of childhood. Expert Opin Drug Discov. 2011; 6(11): 1203-14.
4. Malerba M, Ragnoli B. Ambroxol in the 21st century: pharmacological and clinical update. Expert Opin. Drug Metab Toxicol. 2008; 4(8): 1119-29.
5. Stetinova V, Herout V, Kvetina J. In vitro and in vivo antioxidant activity of ambroxol. Clin Exp Med. 2004; 4(3): 152-8.
6. Gillissen A, Nowak D. Characterization of N-acetylcysteine and ambroxol in anti-oxidant therapy. Respir Med. 1998; 92(4): 609-23.
7. Krenke K, Doniec Z, Mastalerz-Migas A et al. Zalecenia postępowania diagnostyczno-terapeutycznego w kaszlu u dzieci. Lekarz POZ. 2022; 3: 173-92.
8. Wiessmann KJ, Niemeyer K. [Clinical results in the treatment of chronic obstructive bronchitis with ambroxol in comparison with bromhexine (author’s transl)]. Arzneimittelforschung. 1978; 28(5a): 918-21.
9. Wu X, Li S, Zhang J et al. Meta-analysis of high doses of ambroxol treatment for acute lung injury/acute respiratory distress syndrome based on randomized controlled trials. J Clin Pharmacol. 2014; 54(11): 1199-206.
10. Gibbs BF, Wolff HH, Grabbe J. Ambroxol inhibits the release of histamine, leukotrienes and cytokines from human leukocytes and mast cells. Inflamm Res. 1999; 48(2): 86-93.
11. Peroni DG, Moser S, Gallo G et al. Ambroxol inhibits neutrophil respiratory burst activated by alpha chain integrin adhesion. Int J Immunopathol Pharmacol. 2013; 26(4): 883-7.
12. Nowak D, Antczak A, Krol M et al. Antioxidant properties of Ambroxol. Free Radic Biol Med. 1994; 16(4): 517-22.
13. Nowak D, Antczak A, Pietras T et al. Protective effect of ambroxol against heat- and hydrogen peroxide-induced damage to lung lipids in mice. Eur Respir J. 1994; 7(9): 1629-34.
14. Nowak D, Pierscinski G, Drzewoski J. Ambroxol inhibits doxorubicin-induced lipid peroxidation in heart of mice. Free Radic Biol Med. 1995; 19(5): 659-63.
15. Nowak D, Pietras T, Antczak A. Ambroxol inhibits endotoxin-induced lipid peroxidation in mice. Pol J Pharmacol. 1993; 45(3): 317-22.
16. Principi N, Zavattini G, Daniotti S. Possibility of interaction among antibiotics and mucolytics in children. Int J Clin Pharmacol Res. 1986; 6: 369-72.
17. Yamaya M, Nishimura H, Nadine LK et al. Ambroxol inhibits rhinovirus infection in primary cultures of human tracheal epithelial cells. Arch Pharm Res. 2014; 37(4): 520-9.
18. Kantar A, Klimek L, Cazan D et al. An overview of efficacy and safety of ambroxol for the treatment of acute and chronic respiratory diseases with a special regard to children. Multidiscip Respir Med. 2020; 15(1): 511.
19. Lu Q, Yu J, Yang X et al. Ambroxol interferes with Pseudomonas aeruginosa quorum sensing. Int J Antimicrob Agents. 2010; 36(3): 211-5.
20. Schulz M, Hammerlein A, Hinkel U et al. Safety and usage pattern of an over-the-counter ambroxol cough syrup: a community pharmacy-based cohort study. Int J Clin Pharmacol Ther. 2006; 44(9): 409-21.
21. Teramoto S, Suzuki M, Ohga M et al. Effects of ambroxol on spontaneous or stimulated generation of reactive oxygen species by bronchoalveolar lavage cells harvested from patients with or without chronic obstructive pulmonary diseases. Pharmacology. 1999; 59(3): 135-41.
22. Jahnz-Rozyk K, Kucharczyk A, Chcialowski A et al. [The effect of inhaled ambroxol treatment on clinical symptoms and chosen parameters of ventilation in patients with exacerbation of chronic obstructive pulmonary disease patients]. Pol Merkur Lekarski. 2001; 11(63): 239-43.
23. Paganin F, Bouvet O, Chanez P et al. Evaluation of the effects of ambroxol on the ofloxacin concentrations in bronchial tissues in COPD patients with infectious exacerbation. Biopharm Drug Dispos. 1995; 16(5): 393-401.
24. Nowak D. [Antioxidative features of ambroxol – usefulness in COPD]. Pneumonol Alergol Pol. 2001; 69(9-10): 590-3.
25. Malerba M, Ponticiello A, Radaeli A et al. Effect of twelve-months therapy with oral ambroxol in preventing exacerbations in patients with COPD. Double-blind, randomized, multicenter, placebo-controlled study (the AMETHIST Trial). Pulm Pharmacol Ther. 2004; 17(1): 27-34.
26. Yamada T, Takemura Y, Niisato N et al. Action of N-acylated ambroxol derivatives on secretion of chloride ions in human airway epithelia. Biochem Biophys Res Commun. 2009; 380(3): 586-90.
27. Liu H, Wang W, Gao X. Comparison of the efficacy of ambroxol hydrochloride and N -acetylcysteine in the treatment of children with bronchopneumonia and their influence on prognosis. Exp Ther Med. 2020; 20(6): 130. http://doi.org/10.3892/etm.2020.9260.
28. Lu Q, Yu J, Bao L et al. Effects of combined treatment with ambroxol and ciprofloxacin on catheter-associated Pseudomonas aeruginosa biofilms in a rat model. Chemotherapy. 2013; 59(1): 51-6.
29. Rene HD, Jose MS, Isela SN et al. Effects of ambroxol on Candida albicans growth and biofilm formation. Mycoses. 2014; 57(4): 228-32.
30. Wang W, Yu J, He Y et al. Ambroxol inhibits mucoid conversion of Pseudomonas aeruginosa and contributes to the bactericidal activity of ciprofloxacin against mucoid P. aeruginosa biofilms. APMIS. 2016; 124(7): 611-8. http://doi.org/10.1111/apm.12542.
31. Leffler A, Reckzeh J, Nau C. Block of sensory neuronal Na+ channels by the secreolytic ambroxol is associated with an interaction with local anesthetic binding sites. Eur J Pharmacol. 2010; 630(1-3): 19-28.
2. Michnar M, Milanowski J. Ocena kliniczna skuteczności i tolerancji doustnego leczenia ambrosolem u chorych na przewlekłe zapalenie oskrzeli. 7Pneumonol Alergol Pol. 1996; 64(suppl 1): 90-6.
3. Paleari D, Rossi GA, Nicolini G et al. Ambroxol: a multifaceted molecule with additional therapeutic potentials in respiratory disorders of childhood. Expert Opin Drug Discov. 2011; 6(11): 1203-14.
4. Malerba M, Ragnoli B. Ambroxol in the 21st century: pharmacological and clinical update. Expert Opin. Drug Metab Toxicol. 2008; 4(8): 1119-29.
5. Stetinova V, Herout V, Kvetina J. In vitro and in vivo antioxidant activity of ambroxol. Clin Exp Med. 2004; 4(3): 152-8.
6. Gillissen A, Nowak D. Characterization of N-acetylcysteine and ambroxol in anti-oxidant therapy. Respir Med. 1998; 92(4): 609-23.
7. Krenke K, Doniec Z, Mastalerz-Migas A et al. Zalecenia postępowania diagnostyczno-terapeutycznego w kaszlu u dzieci. Lekarz POZ. 2022; 3: 173-92.
8. Wiessmann KJ, Niemeyer K. [Clinical results in the treatment of chronic obstructive bronchitis with ambroxol in comparison with bromhexine (author’s transl)]. Arzneimittelforschung. 1978; 28(5a): 918-21.
9. Wu X, Li S, Zhang J et al. Meta-analysis of high doses of ambroxol treatment for acute lung injury/acute respiratory distress syndrome based on randomized controlled trials. J Clin Pharmacol. 2014; 54(11): 1199-206.
10. Gibbs BF, Wolff HH, Grabbe J. Ambroxol inhibits the release of histamine, leukotrienes and cytokines from human leukocytes and mast cells. Inflamm Res. 1999; 48(2): 86-93.
11. Peroni DG, Moser S, Gallo G et al. Ambroxol inhibits neutrophil respiratory burst activated by alpha chain integrin adhesion. Int J Immunopathol Pharmacol. 2013; 26(4): 883-7.
12. Nowak D, Antczak A, Krol M et al. Antioxidant properties of Ambroxol. Free Radic Biol Med. 1994; 16(4): 517-22.
13. Nowak D, Antczak A, Pietras T et al. Protective effect of ambroxol against heat- and hydrogen peroxide-induced damage to lung lipids in mice. Eur Respir J. 1994; 7(9): 1629-34.
14. Nowak D, Pierscinski G, Drzewoski J. Ambroxol inhibits doxorubicin-induced lipid peroxidation in heart of mice. Free Radic Biol Med. 1995; 19(5): 659-63.
15. Nowak D, Pietras T, Antczak A. Ambroxol inhibits endotoxin-induced lipid peroxidation in mice. Pol J Pharmacol. 1993; 45(3): 317-22.
16. Principi N, Zavattini G, Daniotti S. Possibility of interaction among antibiotics and mucolytics in children. Int J Clin Pharmacol Res. 1986; 6: 369-72.
17. Yamaya M, Nishimura H, Nadine LK et al. Ambroxol inhibits rhinovirus infection in primary cultures of human tracheal epithelial cells. Arch Pharm Res. 2014; 37(4): 520-9.
18. Kantar A, Klimek L, Cazan D et al. An overview of efficacy and safety of ambroxol for the treatment of acute and chronic respiratory diseases with a special regard to children. Multidiscip Respir Med. 2020; 15(1): 511.
19. Lu Q, Yu J, Yang X et al. Ambroxol interferes with Pseudomonas aeruginosa quorum sensing. Int J Antimicrob Agents. 2010; 36(3): 211-5.
20. Schulz M, Hammerlein A, Hinkel U et al. Safety and usage pattern of an over-the-counter ambroxol cough syrup: a community pharmacy-based cohort study. Int J Clin Pharmacol Ther. 2006; 44(9): 409-21.
21. Teramoto S, Suzuki M, Ohga M et al. Effects of ambroxol on spontaneous or stimulated generation of reactive oxygen species by bronchoalveolar lavage cells harvested from patients with or without chronic obstructive pulmonary diseases. Pharmacology. 1999; 59(3): 135-41.
22. Jahnz-Rozyk K, Kucharczyk A, Chcialowski A et al. [The effect of inhaled ambroxol treatment on clinical symptoms and chosen parameters of ventilation in patients with exacerbation of chronic obstructive pulmonary disease patients]. Pol Merkur Lekarski. 2001; 11(63): 239-43.
23. Paganin F, Bouvet O, Chanez P et al. Evaluation of the effects of ambroxol on the ofloxacin concentrations in bronchial tissues in COPD patients with infectious exacerbation. Biopharm Drug Dispos. 1995; 16(5): 393-401.
24. Nowak D. [Antioxidative features of ambroxol – usefulness in COPD]. Pneumonol Alergol Pol. 2001; 69(9-10): 590-3.
25. Malerba M, Ponticiello A, Radaeli A et al. Effect of twelve-months therapy with oral ambroxol in preventing exacerbations in patients with COPD. Double-blind, randomized, multicenter, placebo-controlled study (the AMETHIST Trial). Pulm Pharmacol Ther. 2004; 17(1): 27-34.
26. Yamada T, Takemura Y, Niisato N et al. Action of N-acylated ambroxol derivatives on secretion of chloride ions in human airway epithelia. Biochem Biophys Res Commun. 2009; 380(3): 586-90.
27. Liu H, Wang W, Gao X. Comparison of the efficacy of ambroxol hydrochloride and N -acetylcysteine in the treatment of children with bronchopneumonia and their influence on prognosis. Exp Ther Med. 2020; 20(6): 130. http://doi.org/10.3892/etm.2020.9260.
28. Lu Q, Yu J, Bao L et al. Effects of combined treatment with ambroxol and ciprofloxacin on catheter-associated Pseudomonas aeruginosa biofilms in a rat model. Chemotherapy. 2013; 59(1): 51-6.
29. Rene HD, Jose MS, Isela SN et al. Effects of ambroxol on Candida albicans growth and biofilm formation. Mycoses. 2014; 57(4): 228-32.
30. Wang W, Yu J, He Y et al. Ambroxol inhibits mucoid conversion of Pseudomonas aeruginosa and contributes to the bactericidal activity of ciprofloxacin against mucoid P. aeruginosa biofilms. APMIS. 2016; 124(7): 611-8. http://doi.org/10.1111/apm.12542.
31. Leffler A, Reckzeh J, Nau C. Block of sensory neuronal Na+ channels by the secreolytic ambroxol is associated with an interaction with local anesthetic binding sites. Eur J Pharmacol. 2010; 630(1-3): 19-28.