secretolytic

Secretolytic refers to substances that promote the liquefaction and breakdown of thick secretions in the respiratory tract, with the aim of reducing mucus viscosity and aiding clearance. In practice, many agents described as secretolytics are also labeled mucolytics, though some sources use the term secretolytic to emphasize direct chemical or enzymatic breakdown of mucus cross-links rather than merely altering viscosity.

Mechanism and scope: Secretolytics act by disrupting the structural components of mucus, such as disulfide bonds in mucin glycoproteins, or by otherwise altering mucus composition to make it less viscous. This can improve airway clearance, especially when coughing or inhalation-assisted clearance is needed. Some agents may additionally influence mucus production or ciliary activity, but the primary goal is to facilitate expectoration of secretions.

Common agents and examples: N-acetylcysteine (NAC) is one of the most widely used secretolytics, available in oral and inhaled forms. Other agents with secretolytic effects include carbocisteine and bromhexine. These drugs are used as part of a broader management strategy for productive coughs associated with bronchitis, COPD, bronchiectasis, and cystic fibrosis, and may be chosen based on the setting and route of administration.

Safety and considerations: Adverse effects vary by agent but can include gastrointestinal upset, nausea, stomatitis, or rash. Inhaled secretolytics may provoke bronchospasm in sensitive individuals, particularly some asthma patients. They should be used under medical supervision, with consideration of the underlying condition and hydration status. They are not curative for disease and are typically part of symptomatic management alongside other therapies.