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Cost containment in the EU: an overview
Published in Elias Mossialos, Julian Le Grand, Health Care and Cost Containment in the European Union, 2019
Elias Mossialos, Julian Le Grand
There were, however, additional effects which diminished the extent to which financial savings were achieved. It was estimated that deletion of cough and cold preparations was associated with a threefold increase in the prescription of carbocisteine (a mucolytic agent of doubtful efficacy) which was retained on the list. Similarly the exclusion of antacids from the list resulted in a major rise in prescriptions for H2-histamine antagonists.101
Antioxidant properties and application information
Published in Roger L. McMullen, Antioxidants and the Skin, 2018
N-acetylcysteine is a pharmaceutical active used as a mucolytic agent, which breaks down mucous into a less viscous substance by cleaving disulfide bonds. It is also a nutritional supplement for its antioxidant properties. N-acetylcysteine is also used to treat overdoses of paracetamol (acetaminophen)—an OTC pharmaceutical to treat pain and fever that is often taken to induce self-poisoning. In addition, it is utilized as an antidote for cysteine/glutathione deficiency.
Case studies
Published in Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay, COPD in Primary Care, 2018
Anita Sharma, David Pitchforth, Gail Richards, Joyce Barclay
It is all too easy to enter an exception code and remove the patient from QOF indicators. However, Sarah is the kind of patient who needs education, optimisation of inhaler treatment and regular follow-ups. If she is struggling to attend your surgery, add her name to your regular home visit list.Aim to reduce the frequency and severity of exacerbations by providing a long-acting bronchodilator, a combination inhaler of long-acting β2 and inhaled corticosteroid, mucolytic agent and pulmonary rehabilitation.Introduce a self-management plan with clear instructions with regard to the action plan.Check the patient’s pneumococcal immunisation status and emphasise the importance of having the influenza vaccination every year.Involve social services in providing home help.Assess the need for oxygen therapy.
Bromhexine and its inhibitory effect on lipase – kinetics and structural study
Published in Archives of Physiology and Biochemistry, 2022
Asma Gholami, Dariush Minai-Tehrani, Fereshteh Eftekhar
P. aeruginosa is a Gram-negative and opportunistic pathogenic bacterium which is the important cause of infection, particularly in the patients with cystic fibrosis, burn patients or hospitalised in intensive care units (Pollack 2000, Lyczak et al. 2002, de Bentzmann and Plesiat 2011). In this regard, P. aeruginosa uses some extracellular enzymes to degrade the extracellular matrix of host patients. The important extracellular enzymes produced by P. aeruginosa are protease (Frimmersdorf et al. 2010), elastase A and B (Cryz and Iglewski 1980), phospholipase C (Bever and Iglewski 1988) and lipases (Stuer et al. 1986, Ostroff and Vasil 1987). Some lipases are expressed and secreted by pathogenic organisms during the infection which causes biofilm in skin surface of patients. As a result, any agents that inhibit lipase activity may be important for medicine. Drugs are made to interact with certain receptors or enzymes, but irregularly; some drugs may bind to other enzymes or molecules in the body, which causes some side effect. Bromhexine is a synthetic substance obtained as a synthetic analog of vasicine, a substance found in a plant called Adhatoda vasica (Figure 1). It is a mucolytic agent which is used in the treatment of respiratory disorders associated with viscid or excessive mucus (Ellis and West 1970). In addition, bromhexine has antioxidant properties (Felix et al. 1996) and disrupts the structure of acid mucopolysaccharide fibers in mucoid sputum and produces less viscous mucus.
Acute and chronic non-pulmonary complications in adults with cystic fibrosis
Published in Expert Review of Respiratory Medicine, 2019
Lucile Regard, Clémence Martin, Guillaume Chassagnon, Pierre-Régis Burgel
Nearly all CF patients will present with sinonasal abnormalities on clinical and/or radiographic examination [132]. The sinuses serve as a reservoir for pathogens that may contribute to lower airway colonization and to lower airway disease progression. In CF patients, nasal polyposis prevalence is estimated at 32–44% [133] and chronic rhinosinusitis (CRS) prevalence at 30–65% [134]. CRS diagnosis is based on a combination of clinical symptoms (nasal obstruction or congestion, mucopurulent discharge), endoscopic evidence (nasal polyps), and/or CT findings (sinus opacification, osseous thickening) [135] (Figure 2(g)). Management guidelines for CRS are not specific to the CF population [135] and should be conservative. First-line management includes saline irrigation and/or topical corticosteroids. Some studies suggest that topical antibiotics could improve CF-related CRS symptoms and/or complications [132,136]. Dornase alfa, a mucolytic agent has also been shown to improve CRS, but its availability is currently limited by cost [137]. Surgical treatment should be offered when medical management has failed and patients should be referred to surgeons that are familiar with CF-related sinus disease. CFTR modulators may be beneficial [138] but further research is necessary.
N-acetyl-cysteine reduces the risk for mechanical ventilation and mortality in patients with COVID-19 pneumonia: a two-center retrospective cohort study
Published in Infectious Diseases, 2021
Stelios F. Assimakopoulos, Diamanto Aretha, Dimitris Komninos, Dimitra Dimitropoulou, Maria Lagadinou, Lydia Leonidou, Ioanna Oikonomou, Athanasia Mouzaki, Markos Marangos
Granules for suspension of NAC (Trebon N; 600 mg/sachet, Unipharma Pharmaceutical Laboratories S.A., Greece) was dissolved in half a glass of water and administered orally twice per day. The NAC dosage selection was based on previous studies in respiratory diseases, demonstrating that 1200 mg/d of oral NAC prevents chronic obstructive pulmonary disease exacerbations and exerts antioxidant and anti-inflammatory actions in community-acquired pneumonia [4,5]. There is also extensive clinical experience in diverse clinical entities, showing the high tolerability and safety of this drug, even at much higher doses and for longer periods of administration than the commonly prescribed dose of 600 mg/d as a mucolytic agent [6].