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Ohar JA, Donohue JF, Spangenthal S. The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review. Chronic Obstr Pulm Dis. 2019;6(4)doi: 10.15326/jcopdf.6.4.2019.0139.
Ohar, J. A., Donohue, J. F., & Spangenthal, S. (2019). The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review. Chronic obstructive pulmonary diseases (Miami, Fla.), 6(4), . https://doi.org/10.15326/jcopdf.6.4.2019.0139
Ohar, Jill A, et al. "The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review." Chronic obstructive pulmonary diseases (Miami, Fla.) vol. 6,4 (2019). doi: https://doi.org/10.15326/jcopdf.6.4.2019.0139
Ohar JA, Donohue JF, Spangenthal S. The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review. Chronic Obstr Pulm Dis. 2019 Oct 23;6(4). doi: 10.15326/jcopdf.6.4.2019.0139. PMID: 31647856; PMCID: PMC7006698.
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Chronic Obstr Pulm Dis. 2019 Oct 23;6(4). doi: 10.15326/jcopdf.6.4.2019.0139.

The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review.

Chronic obstructive pulmonary diseases (Miami, Fla.)

Jill A Ohar, James F Donohue, Selwyn Spangenthal

Affiliations

  1. Section of Pulmonary, Critical Care, Allergy, and Immunological Diseases, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
  2. Division of Pulmonary Diseases and Critical Care, Department of Medicine, University of North Carolina, Chapel Hill.
  3. Internal Medicine & Pulmonology, Charlotte Lung & Health Center, Charlotte, North Carolina.

PMID: 31647856 PMCID: PMC7006698 DOI: 10.15326/jcopdf.6.4.2019.0139

Abstract

UNLABELLED: Chronic obstructive pulmonary disease is the third leading cause of death and disease burden worldwide. It includes a spectrum of diseases including chronic bronchitis which is characterized by overproduction, hypersecretion and decreased elimination of mucus. Chronic bronchitis has numerous clinical consequences, including predisposition to lower respiratory tract infections, accelerated decline in lung function, increased exacerbation rate and decreased health-related quality of life.

UNLABELLED: Although the inflammatory mechanisms responsible for mucus cell metaplasia in chronic obstructive pulmonary disease and stable chronic bronchitis are poorly understood, the main goals of therapy are to decrease mucus hypersecretion by controlling inflammation and to increase mucus clearance. Non-pharmacological measures include smoking cessation and chest physiotherapy. Pharmacological interventions include expectorants and mucolytics together with long-acting beta2-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics.

UNLABELLED: Guaifenesin is an expectorant that is thought to increase hydration and decrease viscosity of mucus leading to improved clearance of accumulated secretions from the upper and lower airway. Although guaifenesin has a Food and Drug Administration Over-the-Counter (OFC) Monograph indication to "help loosen phlegm (mucus) and thin bronchial secretions in patients with stable chronic bronchitis," there is limited published evidence of either mechanism of action or clinical efficacy in this disease state. Here we review the pathophysiology and consequences of chronic mucus hypersecretion and examine the evidence for the use of guaifenesin in patients with stable chronic bronchitis.

JCOPDF © 2019.

Keywords: chronic bronchitis; chronic mucus hypersecretion; chronic obstructive pulmonary disease; copd; expectorants; guaifenesin; stable chronic bronchitis

Conflict of interest statement

All authors participated in a stable chronic bronchitis clinical advisory board meeting supported by Reckitt Benckiser in September 2018 for which they received a consultancy fee. Additionally, J. Oha

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