The prescription of drugs to aid expectoration is as old as medicine, and mixtures in use in ancient Rome have been prescribed until very recently, for example syrup of squills. None of the traditional remedies other than steam inhalation has been shown to work. Have modern drugs done better? The pharmacological activity of acetylcysteine (Airbron) and bromhexine (Bisolvon) led to the promotion of these drugs as mucolytic agents. Clinically however they have been disappointing,1 and so far no satisfactory controlled trials support their use. S-carboxy-methylcysteine (Mucodyne - Berk) has recently been introduced with claims that it reduces the viscosity of mucus in the respiratory tract and facilitates expectoration.
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