Table 1.

Mucoactive medications and their presumed actions

Mucoactive agent	Potential mechanisms of action
Expectorants
Mannitol powder
Hypertonic saline	Increases secretion volume and perhaps hydration
Classical mucolytics
N-acetylcysteine	Severs disulfide bond linking mucin oligomers
Ambroxil	Increases chloride secretion and severs disulfide bonds
Peptide mucolytics
Dornase alfa	Hydrolyzes DNA polymer with reduction in DNA length
Gelsolin or Thymosin β4	Depolymerizes F-actin
Non-destructive mucolytics
Dextran	Breaks hydrogen bonds
Mucoregulatory agents
Anticholinergic agents	Decreases volume of stimulated secretions
Glucocorticoids	Decreases airway inflammation and mucin secretion
Indomethacin	Decrease airway inflammation
Macrolide antibiotics	Decreases airway inflammation and mucin secretion
Cough clearance promoters
Bronchodilators	Can improve cough by increasing expiratory flow
Surfactants	Decreases sputum adhesiveness