Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease (COPD) is the third most fatal disease globally. Acute deterioration of the patient's respiratory symptoms is known as an acute exacerbation of COPD (AECOPD), that goes beyond usual variations and result in change in medications. Ambroxol (ABX...

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Main Authors: Aswin A. Anil, Devendu Rajesh, Aishwarya Laxmi Krishnan, Ciciliya Arun, Rosemary Thomas, Prashant Chandra, Nithya Haridas
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:Clinical Epidemiology and Global Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S2213398424002860
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author Aswin A. Anil
Devendu Rajesh
Aishwarya Laxmi Krishnan
Ciciliya Arun
Rosemary Thomas
Prashant Chandra
Nithya Haridas
author_facet Aswin A. Anil
Devendu Rajesh
Aishwarya Laxmi Krishnan
Ciciliya Arun
Rosemary Thomas
Prashant Chandra
Nithya Haridas
author_sort Aswin A. Anil
collection DOAJ
description Introduction: Chronic obstructive pulmonary disease (COPD) is the third most fatal disease globally. Acute deterioration of the patient's respiratory symptoms is known as an acute exacerbation of COPD (AECOPD), that goes beyond usual variations and result in change in medications. Ambroxol (ABX) and N-acetylcysteine (NAC), are mainly used as mucolytics in the treatment of AECOPD. Methodology: This prospective observational study examines effectiveness of ABX and NAC in COPD patients by assessing the quality of cough relief, peak expiratory flow rate (PEFR), length of hospital stay, quality of life (QOL) and reduction in symptoms of COPD. Leicester Cough Questionnaire (LCQ); Breathlessness, Cough and Sputum scale (BCSS)and St. George Respiratory Questionnaire (SGRQ) scales are used to evaluate patient condition before and after the treatment. Results: The mean duration of hospital stay for NAC and ABX were found to be 8 ± 3.6 and 9.9 ± 3.9 days, respectively. Lung function in both groups improved with a change in percentage mean score of PEFR. Reduction in symptoms of COPD was evident in both groups by decrease in mean BCSS score from admission to discharge. Our study also demonstrated better QOL in both groups using SGRQ. LCQ showed a mean increase in all domains: physical, psychological and social. Conclusion: It was concluded that both ABX and NAC leads to betterment in lung function, cough relief and control AECOPD. Hence, this study gives a signal to clinicians about these treatment options along with standard therapy of COPD for a better therapeutic outcome.
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spelling doaj-art-fb4b63b2c50c4e01b7946bcecbea5ccf2025-08-20T02:01:33ZengElsevierClinical Epidemiology and Global Health2213-39842024-11-013010178910.1016/j.cegh.2024.101789Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary diseaseAswin A. Anil0Devendu Rajesh1Aishwarya Laxmi Krishnan2Ciciliya Arun3Rosemary Thomas4Prashant Chandra5Nithya Haridas6Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, IndiaDepartment of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, IndiaDepartment of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, IndiaDepartment of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, IndiaDepartment of Community Medicine, PK Das Institute of Medical Sciences, Vaniyamkulam, Palakkad, Kerala, 679522, IndiaDepartment of Pharmacy Practice, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, India; Corresponding author.Department of Respiratory Medicine, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, 682041, IndiaIntroduction: Chronic obstructive pulmonary disease (COPD) is the third most fatal disease globally. Acute deterioration of the patient's respiratory symptoms is known as an acute exacerbation of COPD (AECOPD), that goes beyond usual variations and result in change in medications. Ambroxol (ABX) and N-acetylcysteine (NAC), are mainly used as mucolytics in the treatment of AECOPD. Methodology: This prospective observational study examines effectiveness of ABX and NAC in COPD patients by assessing the quality of cough relief, peak expiratory flow rate (PEFR), length of hospital stay, quality of life (QOL) and reduction in symptoms of COPD. Leicester Cough Questionnaire (LCQ); Breathlessness, Cough and Sputum scale (BCSS)and St. George Respiratory Questionnaire (SGRQ) scales are used to evaluate patient condition before and after the treatment. Results: The mean duration of hospital stay for NAC and ABX were found to be 8 ± 3.6 and 9.9 ± 3.9 days, respectively. Lung function in both groups improved with a change in percentage mean score of PEFR. Reduction in symptoms of COPD was evident in both groups by decrease in mean BCSS score from admission to discharge. Our study also demonstrated better QOL in both groups using SGRQ. LCQ showed a mean increase in all domains: physical, psychological and social. Conclusion: It was concluded that both ABX and NAC leads to betterment in lung function, cough relief and control AECOPD. Hence, this study gives a signal to clinicians about these treatment options along with standard therapy of COPD for a better therapeutic outcome.http://www.sciencedirect.com/science/article/pii/S2213398424002860AECOPDAmbroxolN-acetylcysteineLung functionQuality of life
spellingShingle Aswin A. Anil
Devendu Rajesh
Aishwarya Laxmi Krishnan
Ciciliya Arun
Rosemary Thomas
Prashant Chandra
Nithya Haridas
Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
Clinical Epidemiology and Global Health
AECOPD
Ambroxol
N-acetylcysteine
Lung function
Quality of life
title Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
title_full Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
title_fullStr Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
title_full_unstemmed Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
title_short Evaluating the mucolytic effectiveness of Ambroxol and N-Acetylcysteine in patients with Acute exacerbation of chronic obstructive pulmonary disease
title_sort evaluating the mucolytic effectiveness of ambroxol and n acetylcysteine in patients with acute exacerbation of chronic obstructive pulmonary disease
topic AECOPD
Ambroxol
N-acetylcysteine
Lung function
Quality of life
url http://www.sciencedirect.com/science/article/pii/S2213398424002860
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