Acetylcysteine vs Bromhexine for Loosening Cough: 18 flashcards
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1. What class of drugs do acetylcysteine and bromhexine both belong to?
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Mucolytics — agents that thin mucus so it can be coughed up.
2. How does acetylcysteine thin mucus?
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It breaks the disulfide (–S–S–) bonds that cross-link mucus glycoproteins.
3. How does bromhexine reduce mucus viscosity?
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It increases serous bronchial secretion and surfactant production.
4. Which drug acts directly on mucus already present in the airway?
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Acetylcysteine — its chemical action does not require a gland response.
5. Which drug's effect builds over hours to days?
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Bromhexine — it works through gland secretion, so onset is slower.
6. What is the distinctive non-respiratory use of acetylcysteine?
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It is the antidote for paracetamol (acetaminophen) overdose.
7. Are acetylcysteine and bromhexine cough suppressants?
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No — they loosen mucus so it can be coughed up; they do not stop the cough.
8. What routes can acetylcysteine be given by?
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Oral, inhaled, or intravenous.
9. What is the typical route for bromhexine?
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Oral.
10. What structural feature makes mucus thick and tenacious?
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Long glycoprotein chains cross-linked by disulfide bonds.
11. What group does acetylcysteine donate to break disulfide bridges?
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A free sulfhydryl (–SH) group.
12. Why is bromhexine sometimes called a mucoregulator or mucokinetic?
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Because it shifts the quality of gland secretion rather than chemically cleaving existing mucus.
13. What does bromhexine increase in the alveoli that reduces mucus stickiness?
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Surfactant.
14. Is there a universal 'better' drug between acetylcysteine and bromhexine?
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No — choice depends on mucus type, patient factors, and treatment goals.
15. What three factors guide selection between acetylcysteine and bromhexine?
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Mucus type, patient factors, and severity/duration goals.
16. What is the shared goal of both drugs in a loose cough?
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To loosen and mobilise mucus so it can be cleared by coughing.
17. Why is acetylcysteine described as a 'true mucolytic'?
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Because it chemically cleaves mucus structure directly, independent of gland response.
18. What happens if a productive cough is suppressed instead of loosened?
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Secretions can be trapped in the airways.
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