ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 22 of 58
Up
УЖМБС 2020, 5(6): 158–162
https://doi.org/10.26693/jmbs05.06.158
Clinical Medicine

Peculiarities of Prescribing Mucolytic Therapy to Children in Post-Attack Period of Bronchial Asthma

Sazhyn S. I.
Abstract

Bronchial asthma is the most common chronic pathology in childhood. Chronic inflammatory process of the respiratory tract forms bronchial hyperreactivity which is manifested by typical clinical symptoms. Like any other chronic disorder, the course of bronchial asthma consists of periods of exacerbation and remission. A productive cough in the post-attack period determines the prescription of mucolytic drugs by doctors to liquefy viscous sputum, to remove it more quickly, especially among the paediatric population. There are different approaches to prescribing mucolytic drugs during exacerbation of symptoms of bronchial asthma in scientific publications. The purpose of the study was to evaluate the clinical effectiveness of mucolytic therapy in children with bronchial asthma to optimize the treatment of disease exacerbations. Material and methods. One hundred two medical records of patients treated for asthma exacerbation in pulmonological department of the Chernivtsi Regional Children Clinical Hospital were analyzed. Four clinical groups were formed depending on the prescription of mucolytic drugs. There were not any significant differences by sex, place of residence, however the average age of patients who were prescribed carbocisteine. It was significantly less than in children of other clinical groups. Results and discussion. It was determined that acetylcysteine and carbocysteine were prescribed to patients on the first day of the productive cough onset. Instead to children of the IV clinical group where ambroxol was prescribed on average 1.6 days before the wet cough onset. The study results showed that the average duration of hospitalization in patients receiving ambroxol was 1.5 days less than in children taking acetylcysteine or carbocysteine. The difference was significant. However, the duration of hospitalization for children of I clinical group was not significant longer in comparison with patients received drugs with mucolytic effect in the complex therapy of asthma exacerbation. Conclusion. Despite the fact that acetylcysteine and carbocysteine were significantly more often prescribed for more severe and pronounced asthma exacerbation a decrease in the relative and absolute risks of longer hospitalization was observed in patients taking carbocysteine

Keywords: children, bronchial asthma, mucolytics

Full text: PDF (Ukr) 274K

References
  1. Chronic Respiratory Disease. [Internet] World Health Organisation. 2018. Available from: https://www.who.int/respiratory/asthma/en/
  2. Global Strategy for Asthma Management and Prevention. [Internet]. Global Initiative for Asthma. 2020. Available from: https://ginasthma.org/wp-content/uploads/2020/04/GINA-2020-full-report_-final-_wms.pdf
  3. Order of the Ministry of Health of Ukraine of October, 08, 2013 № 868. Pro zatverdzhennya ta vprovadzhennya medyko-tekhnologichnykh dokumentiv zi standartyzatsiyi medychnoyi dopomogy pry bronkhialniy astmi [On the approval and implementation of medical and technological documents for standardization of medical care in bronchial asthma]. [Internet] Available from: https://zakon.rada.gov.ua/rada/show/v0868282-13#Text
  4. Nikolayenko VB. Mukoregulyator, antyoksydant, pnevmoprotektor — suchasne uyavlennya pro mistse atsetyltsysteyinu v terapiyi zakhvoryuvan respiratornoyi systemy [Mucoregulator, antioxidant, pneumoprotector – a modern conception of the role of acetylcysteine in treatment of respiratory system diseaseas]. Ukrayinskyy medychnyy chasopys. 2019; 1(1): 69-74. [Ukrainian]. https://doi.org/10.32471/umj.1680-3051.129.136819
  5. Okhotnikova EN. Syndrom obstruktsyy dykhatelnykh putey u detey: trudnye voprosy – vernye reshenyya [Airway obstruction syndrome in children: the difficult questions — the right decisions]. Zdorove rebenka. 2016; 1(69): 88-96. [Russian]
  6. Kramarov SO. Kashel u ditey. Mozhlyvosti likuvannya [Cough in children: treatment options]. Sovremennaya pediatriya. 2018: 4(92): 98-104. [Ukrainian]. doi 10.15574/SP.2018.92.98
  7. Poole P, Sathananthan K, Fortescue R. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary. Cochrane Database of Systematic Reviews. 2019; 5 (CD001287). https://doi.org/10.1002/14651858.CD001287.pub6
  8. Fletcher R, Fletcher S, Vagner E, Bashchinskiy SE. Klinicheskaya epidemiologiya. Osnovy dokazatel'noy meditsiny [Clinical epidemiology. Basics of Evidence-Based Medicine]. M: Media Sfera; 2004. 352 p. [Russian]
  9. Papadopoulos NG, Čustović A, Cabana MD, Dell SD, Deschildre A, Hedlin G, et al. Pediatric asthma: An unmet need for more effective, focused treatments. Pediatr Allergy Immunol. 2019; 30: 7-16. https://doi.org/10.1111/pai.12990
  10. Kvashnina LV. Mukolitychna terapiya u dytyachomu vitsi: mozhlyvosti, efektyvnist, bezpeka [Mukolitic therapy in childhood: opportunities, efficacy, safety]. Sovremennaya pediatriya. 2017; 5(85): 41-7. [Ukrainian]. https://doi.org/0.15574/SP.2017.85.41
  11. Okhotnikova OM. Pomylky nadannya nevidkladnoyi dopomogy ta intensyvnoyi terapiyi dityam z bronkhialnoyu astmoyu [Mistakes of management principles of pathogenetic therapy of urgent condition in children with bronchial asthma]. Klinichna imunologiya. Alergologiya. Infektologiya. 2017; 2 (99): 6-17. [Ukrainian]
  12. Rechkina OO. Mistse mukolitykiv u pediatrychniy praktytsi [Place of mucolytics in paediatric practice]. Sovremennaya pediatriya. 2018; 5(93): 94-8. https://doi.org/0.15574/SP.2017.85.41 [Ukrainian]
  13. Du X, Zhao C, Liu S, Su S. Value of ambroxol in the treatment of asthmatic bronchitis. Pak J Med Sci. 2020; 36(3): 501-4. https://doi.org/10.12669/pjms.36.3.1607