MANAGEMENT IN CASE (RHINOSINUSITIS) | Tutorial B-1 RS

Mucolytic Mucus Composition: 95% water (need for water intake to replenish and mucus doesnt easily absorb water once created) , 3% protein and carbohydrates, 1% lipids, less than 0.3% DNA Glycoproteins: Large (macro) molecules Strands of polypeptides (protein) that make up the backbone of the molecule string of amino acid Carbohydrate side chains Chemical bonds hold mucus together Intramolecular: dipeptide links to connect amino acids Intermolecular: disulfide and hydrogen bonds to connect adjacent macromolecules Different with expectorantworks by signaling the body to increase the amount or hydration of secretions, resulting in more yet clearer secretions and as a byproduct lubricating the irritated respiratory tract. One expectorantguaifenesinis commonly available in many cough syrups. Often the term "expectorant" is incorrectly extended to any cough medicine, since it is a universal component Function: Weakening of intermolecular forces binding adjacent glycoprotein chains by disruption of disulphide bonds Acetylcysteine breaks the bonds by substituting a sulfhydril radical (SH)

Alteration of pH to weaken sugar side chains of glycoprotein 2% of NaHCO3 solutions are used to increased the pH of mucus by weakening carbohydrates side chains Can be injected directly into the trachea or aerosolized (2-5 mL) Destruction of protein (proteolysis) contain in the glycoprotein core of proteolytic enzymes by breaking down of DNA in mucus By attacks the protein component of the mucus using Dornase Alpha (Pulmozyme)

Ambroxol 3 x 30 mg MoA: hydrolysis disulphide chain in mucous polymer mucous become thinner and less viscous secretions mucous more easily to drainage and clearance Contraindication: hypersensitivity Side Effect: GI symptom, runny nose, allergic reactions Pregnancy Category: C Dosage: Adults: daily dose of 30 mg (1 Ambroxol tablet) to 120 mg (4 Ambroxol tablets) taken in 2-3 divided doses Children 5 years: 1 tsp Ambroxol syrup 2-3x daily Have a fast onset (