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PubMed1982

Study on the influence of NA-872 (ambroxol) and dexamethasone on the differentiation of Clara cells in albino mice.

The techniques of light and electron microscopy were used to study the sequence of changes in the fine structure of the developing nonciliated bronchiolar cells in the last quarter of gestation in the mouse, and up to the 3rd postnatal day. Control animals were compared with two groups that received either dexamethasone or ambroxol. At the beginning of the study no identifiable Clara cells were seen in any group, and phenotypically differentiated cells were seen until 1 day post partum in every group examined. Dexamethasone appears to increase the glycogen deposition found in the cells, reaching its maximum 1 day prior to delivery. Ambroxol induced an earlier development of the secretory organelles, beginning on day 17 of gestation. In the differentiated cells more secretory dense granules were found in this group; and at the 3rd day post partum a great accumulation of secretory product that filled large areas of cytoplasm was seen only in the ambroxol-treated group. The significance of these finding is discussed.

Ambroxol↗
PubMed1987

Ambroxol in the treatment of idiopathic respiratory distress syndrome. An interim report on a controlled double-blind multicenter study versus placebo.

In a double-blind multicenter study versus placebo, the therapeutic effects of ambroxol (10 mg/kg, i.v. twice daily for 7 days) were studied in an appropriately selected population with severe respiratory failure. Treatment was given to 28 neonates with birth weight less than or equal to 2,000 g, appropriate for gestational age with idiopathic respiratory distress of such severity as to require assisted ventilation (IMV or IPPV) within 12 h of birth. The preliminary results showed that ambroxol treatment, and not placebo, increased survival, reduced the time during which mechanical ventilation was required and improved the FiO2/PaO2 ratio and the biochemical indices of pulmonary maturity. This latter improvement suggests that the amelioration of the IRDS clinical picture and the reduction of ventilatory requirement might be due to an increase in pulmonary surfactant. No side effects attributable to ambroxol therapy were observed in the treated infants.

Ambroxol↗
PubMed1985

Lack of effect of ambroxol, a bronchial secretolytic agent, on gastric mucus in man.

The effect of ambroxol, a bronchial mucolytic agent, on gastric mucus was investigated in man. Ten patients with bronchial hypersecretion were treated with ambroxol 30 mg t.i.d. by the oral route for 10 days. Before and after treatment the amount of total mucoproteins in the gastric juice was measured and a 'mucoprotective index' was calculated. Neither quantitative nor qualitative changes in gastric mucus were observed after ambroxol treatment. Our results show that the drug does not exert lytic effects on the gastric mucus layer and hence is devoid of damaging activity on the gastric mucosa.

Aged↗
PubMed1987

A controlled trial of ambroxol in chronic bronchitis.

Ambroxol is a mucolytic agent which is widely used in chronic bronchitis in Europe. We conducted a double-blind randomized controlled trial of ambroxol vs matched placebo in 90 patients with chronic bronchitis and difficulty clearing secretions. It was concluded that there was no advantage to taking ambroxol.

Ambroxol↗
PubMed2000

[The effectiveness of prenatal steroid and ambroxol therapy for the prevention of respiratory distress syndrome in newborns of diabetic mothers].

The aim of the study was to determine the effectiveness of antenatal steroids and ambroxol in reduction of respiratory distress syndrome (RDS) in newborns of diabetic mothers. A retrospective chart review was done on 101 diabetic gravidas who were hospitalised at 1st Department of Obstetrics and Gynaecology Medical University in Warsaw between January 1989 and December 1999. We studied the neonatal outcomes for women with diabetes mellitus who delivered before 37 gestational weeks depend on exposition to antenatal steroids or ambroxol. Both groups were compared with unexposed neonates for respiratory distress syndrome. Frequency of occurrence and severity of RDS were similar in all study subgroups. We did not found reduction of respiratory distress syndrome in newborns of diabetic mothers exposed to antenatal steroids or ambroxol.

Adult↗
PubMed1992

The influence of Ambroxol on peroxidative processes in lung and plasma in dogs after pulmonectomy.

The purpose of the studies was to determine the effect of Ambroxol on the activity of antioxidant enzymes and on the glutathione level as well as the intensity of the peroxidative processes in the lung tissue, alveolar macrophages and plasma in dogs after unilateral pulmonectomy. On the 2nd and 6th day after the surgery the activity of antioxidant enzymes and the glutathione level were studied in the remaining lung. The levels of the lipid peroxidation products were determined in the analogous system. In both examined groups the increase in the antioxidant enzyme activity and the lipid peroxidation product levels was observed in the remaining lung after the surgery. In Ambroxol-treated animals the statistically significant increase in the antioxidant enzyme activity was noted while the intensity of peroxidative processes was found to be lower. This fact may suggest that Ambroxol stimulates the resistance of the lung tissue to the free radical activity and inhibits the lung peroxidative processes in dogs after pulmonectomy.

Ambroxol↗
PubMed2005

[Prophylactic effect of ambroxol on acute hydrochloric acid aspiration - induced lung injury].

OBJECTIVE: To evaluate the protective effect of ambroxol, a muco-active drug, on acute hydrochloric acid-induced lung injury in rats. METHODS: Thirty pathogen-free SD rats were randomly divided into three groups: group A (n=10) and group B (n=10) were injected normal saline (NS) intraperitoneally (6.7 ml/kg), and group C with ambroxol (50 mg/kg), once a day for 3 consecutive days. Then animals received in tracheal instillation of NS (group A, pH 5.3, 1.2 ml/kg) or hydrochloric acid/NS (group B and C, pH 1.25, 1.2 ml/kg). Five hours after instillation of the injury vehicle, the arterial gas was determined, and the extent of lung injury was assessed by measuring the ratio of wet to dry weight (W/D) and evaluation of pathological change in lung tissue. RESULTS: (1)Partial pressure of oxygen in arterial blood (PaO(2)) was significantly lower in group B than in groups A and C, although pH and partial pressure of carbon dioxide in arterial blood (PaCO(2)) in three groups showed little difference (all P<0.01). (2)The W/D was the highest in group B and the lowest in group A. (3)Severe acute lung injuries were detected in group B by pathological examination, the extent of injury was less in group C than in group B, but more severe than in group A (group A vs. B and B vs. C in mean pathologic score, P<0.01 and P<0.05, respectively). CONCLUSION: Hydrochloric-acid aspiration may induce an acute and diffuse lung injury, with manifestations of hyperpnea, lower PaO(2) and severe pathological changes in lung tissues. Ambroxol may have a protective effect against lung injury induced by hydrochloric acid.

Acute Lung Injury↗
PubMed2004

[Oxidative and anti-oxidative effects of ambroxol on acute hydrochloric acid-induced lung injury in rats].

OBJECTIVE: To evaluate the protective effect of ambroxol on acute hydrochloric acid-induced lung injury in rats. METHODS: Thirty pathogen-free SD rats were randomly divided into 3 groups: Group A (n=10) served as control group, and received intracheal instillation of normal saline (NS, pH5.3, 1.2 ml/kg) with pre-treatment of intraperitoneal NS; Group B (n=10) received intracheal instillation of hydrochloric acid /NS (pH1.25, 1.2 ml/kg) with pre-treatment of intraperitoneal NS; and Group C received intracheal instillation of hydrochloric acid /NS (pH1.25, 1.2 ml/kg) with pre-treatment of intraperitoneal ambroxol (50 mg/kg/d, 3 days). Five hours after the instillation of the injury vehicle, the arterial gas was examined, the levels of superoxide dismutase (SOD), malondialdehyde (MDA) in the blood and homogenate of harvested lung were assayed respectively. RESULTS: PaO2 in Group B was significantly lower than that in Group A and C (P < 0.01), and pH and PaCO2 in the 3 groups had little difference (P > 0.05). MDA in the lungs of Group B increased obviously, and levels of SOD in the lung and blood decreased significantly in Group B (Group B vs Group A, P < 0.01). Levels of SOD of Group C in the lung and blood were markedly higher than those of Group B (P < 0.01), MDA of Group C was obviously lower than that of Group B (P < 0.01), and MDA of blood in the 3 groups had no significant difference (P > 0.05). CONCLUSION: Ambroxol can inhibit lipid peroxidation and increase antioxidant activity, which may be one of the mechanisms in protecting lung tissue from hydrochloric acid-induced injury.

Ambroxol↗
PubMedDate not supplied

[Value of ambroxol in treatment of bronchial asthma and spastic bronchitis].

Ambroxol (Bronchopront-Mack) was administered to 73 patients with the bronchial asthma and spastic bronchitis with expectoration disorders. The drug was given in the dosage forms of slow release capsules, syrup, drops, intramuscular injections and inhalations for about 14 days. All patients have been carefully examined clinically, PEF has been measured, and sputum physico-chemical properties have been tested prior to and 10 days after treatment. Complete disappearance of cough, liquefaction of sputum and clearance of airways have been achieved in 47% of patients. A significant improvement has been noted in 38.4% of cases. The treatment failed in 2.7% of patients. Ambroxol has been well tolerated. No adverse effects on laboratory findings have been noted. Results suggest, that ambroxol is valuable drug in the combined treatment of patients with the bronchial asthma and spastic bronchitis.

Adult↗
PubMed2006

[Influence of ambroxol on paraquat-induced lung tissue injury and change of pulmonary surfactant-associated protein A in the experimental rats].

OBJECTIVE: To investigate the influence of ambroxol on paraquat poisoning induced acute lung tissue injury and the change of pulmonary surfactant associated protein A in the experimental rats. METHODS: One hundred and twenty healthy adult male Sprague-Dawley rats were randomizedly assigned into normal saline (NS) group (n = 24), paraquat poisoning induced lung tissue injury model (PQ) group (n = 48) and ambroxol treatment (AT) group (n = 48). The indexes were observed among the three groups comprising the mortality rate, the change of arterial blood PaCO(2) and PaO(2), the ratio of wet to dry lung tissue (W/D), the change of the lung tissue under light and electric microscope respectively, and the expression of pulmonary surfactant associated protein A. RESULTS: The mortality rate of rats in the PQ group was 50.0% on the seventh day while the mortality rate in the AT group was 25.0%. The level of arterial blood PaCO(2) in the PQ group (6.94 +/- 0.8) kPa was significantly higher than that in the AT group (6.12 +/- 0.5) kPa and the NS group (4.6 +/- 0.4) kPa. The level of arterial blood PaO(2) in the PQ group (6.98 +/- 1.1) kPa was significantly lower than that in the AT group (8.25 +/- 0.7) kPa and the NS group (12.7 +/- 0.8) kPa. There were significant differences among the groups (P < 0.05). The degree of lung tissue injury was severe in PQ group and relieved in AT group. The expression of pulmonary surfactant associated protein A was significantly decreased in PQ group 13.22% +/- 2.21% on the seventh day, compared with that in the AT group (21.82% +/- 3.67%) (P < 0.05). The expression of pulmonary surfactant associated protein A in AT group was significantly higher in the AT group (18.97% +/- 0.91%) than that in the PQ group on the seventh day (P < 0.05). CONCLUSION: Ambroxol plays a role in facilitating synthesis and secretion of pulmonary surfactant protein A and relieves the lung tissue injury induced by paraquat poisoning.

Ambroxol↗
PubMed1991

[Surfactant and ambroxol in the therapy of idiopathic respiratory syndrome in newborn infants].

The Authors have carried out a study on 30 newborns, affected by idiopathic respiratory distress syndrome (IRDS), divided into 3 statistically comparable groups, treated, in addition to mechanical ventilation, respectively with Tokio-Akita (TA) surfactant, placebo (both by endotracheal administration) and ambroxol given by intravenous infusion. The clinical evolution of the three groups was studied, above all as related to mortality, ventilation length, oxygen need, immediate and successive pulmonary complications and cerebral haemorrhage. Mortality was lower in the group treated with ambroxol, while the ventilation length, the average insufflation pressure and the oxygen need were lower in the group treated with surfactant, compared with the other two groups. Pulmonary complications were present only in the group treated with placebo and ambroxol, whereas cerebral haemorrhage rate is higher in the group treated with surfactant. On the basis of the results achieved, some important observations are suggested and possible aetiological therapies of IRDS are formulated.

Ambroxol↗
PubMed1986

Ambroxol and pulmonary toxicity induced by antineoplastic drugs.

The authors describe the potential effects of ambroxol on the pulmonary disorders induced by antineoplastic agents (in particular, bleomycin and the nitrosureas). An experimental stage focussed attention on the early modifications occurring in the alveolar surfactant and in the afflux of inflammatory and immune-effector cells following bleomycin-induced lung fibrosis in the rat (by intratracheal instillation). The ambroxol-protected rats showed a slower drop of alveolar lecithins in the first few hours after bleomycin administration and a lower afflux of neutrophils, macrophages and lymphocytes. In the clinical stage, respiratory function was studied in two groups of cancer patients treated with nitrosureas or bleomycin. Preliminary findings indicate a rapid worsening of some functional parameters--maximal expiratory flow at 25% vital capacity, diffusing capacity for carbon monoxide and diffusing capacity/ventilation--in controls, while no such changes occurred in the ambroxol-protected subjects. The possible pathogenetic implications of these results and perspective for future investigations are discussed.

Ambroxol↗
PubMed1989

[Prophylaxis and treatment of bronchopulmonary complications with ambroxol administered by infusion in elderly patients undergoing surgery].

The Authors consider the high number of patients who are affected with chronic obstructive bronchitis due to various factors (cigarettes smoking, infections, pollution, reduced immune response). These patients, when submitted to middle-high abdominal surgery in total anaesthesia of middle-long duration, are at increased risk due to pulmonary complications. Therefore, an adequate respiratory protection is necessary; actually it is possible with high dose of Ambroxol (1 g). Two groups, both of 35 patients, were compared; the first group was treated with Ambroxol 1 g the second one with aminophilline, bromexine, B2 adrenergic agonists, corticosteroids. The results show the efficacy of respiratory protection by using Ambroxol 1g.

Adult↗
PubMed1989

[Effect of ambroxol on surfactant lipids in patients after resection of pulmonary tissue].

Effect of Ambroxol on phospholipids and higher fatty acids of pulmonary surfactant was studied in patients with lung cancer undergoing pulmonary resection. Intravenous administration of Ambroxol was carried out for 8 days in a dose 1000 mg per day before pulmonary resection. It produced elevation of disaturated phosphatidylcholine and the general level of phosphatidylcholine. Also increase of palmitic acid and saturated fatty acids of the phospholipid fraction was found. The results of this study show that Ambroxol on a short time elevates levels of active substances of pulmonary surfactant and decreases the destructive processes of pulmonary parenchyma.

Adult↗
PubMed1989

[A controlled study on the action of a new formulation of ambroxol in asthmatiform bronchitis in children].

A comparison between the action of Ambroxol and Acetylcysteine was carried out in 28 children aged 2 to 13 (mean 7 years 3 months) affected with spastic bronchitis. 14 patients were treated daily for 10 days by the oral route with 30 mg of Ambroxol (2 sachets) and 14 with 200-300 mg of Acetylcysteine (2-3 sachets). Quantity and quality of sputum, difficulty in expectorating, cough, dyspnea, bronchial bruits, were assessed before the treatment, 5 days into it and at the end. Both drugs were effective and well tolerated, but Ambroxol proved to be more rapid in achieving a satisfactory improvement than Acetylcysteine.

Acetylcysteine↗
PubMed1988

Clinical trial of ambroxol (Mucosolvan) in Sjögren's syndrome.

A clinical trial is described in which twelve patients with Sjögren's Syndrome (SS) were given a dose of 135 mg ambroxol (Mucosolvan) daily for eight weeks. Nine of the patients completed the trial. Three patients dropped out because they developed side effects (generalized rashes in two patients and stomatitis in one). The side effects, however, were mild and cleared off after cessation of treatment. Ambroxol improved sicca symptoms, especially ocular symptoms, in the SS patients, although lacrimal and salivary gland functions measured by Schirmer test or gum test were not changed. Furthermore, the treatment did not alter any chemical findings determined in the stimulated tear and saliva. Our results suggest that ambroxol is useful for the management of sicca symptoms in some patients with SS.

Adult↗
PubMed1985

[Modulation of alveolar macrophage activity by ambroxol, bromhexine and exogenous arachidonic acid].

The increased generation of reactive oxygen metabolites (ROM) (O2-, H2O2, 1O2, X OH, OX-) by alveolar macrophages (AM) and neutrophils has been proposed as an important step in the pathogenesis of many acute and chronic lung disorders. With regard to a possible therapeutic application in this context the effect of bromhexine and ambroxol on the activity of AM of of guinea-pigs and of patients with lung diseases was investigated. The activity of AM, which were isolated by bronchoalveolar lavage, was determined by means of chemiluminescence (CL)-measuring. Ambroxol and bromhexine cause a depression of the spontaneous as well as of the induced CL [yeast cell walls, yeast glucan, exogenous arachidonic acid (AA)] of AM. AM from guinea-pigs and in some cases also from patients show primarily an increase of the CL-signal under the influence of bromhexine. These results suggest that ambroxol and bromhexine reduce the production of ROM by AM. The mechanism is possibly due to the activation of acyl-CoA-lysophosphatide acyltransferase. The increase of this enzyme activity lowers the intracellular concentration of the free AA, whereby the generation of ROM is diminished too. The investigations exhibit a new possibility of influence of respiratory burst and thus indirectly of AA-liberation from phospholipids. The probable reduction of AA-liberation by these drugs could also be of importance for other lung cells especially concerning the biosynthesis of eicosanoids (AA-metabolites), which play an important part as pathogenetic mediators in different lung diseases.

Ambroxol↗
PubMed1987

Influence of ambroxol on tracheobronchial clearance in simple chronic bronchitis.

The influence on tracheobronchial clearance of ambroxol, a metabolite of bromhexine, was investigated by measuring the lung retention of inhaled 6 micron monodisperse Teflon particles labelled with 99mTc. Fourteen subjects with simple chronic bronchitis, who belonged to a "responder" group in an earlier study on the subjective effects of ambroxol, were examined using a double-blind cross-over design comparing 120 mg ambroxol daily and placebo. On commencing the study and after each 2-week treatment period, the subjects were examined for mucociliary clearance and clearance by voluntary coughing. Treatment did not influence mucociliary clearance or clearance by cough. There is still a possibility that phlegm loosening by cough is enhanced in situations with more hypersecretion.

Adult↗