From the Guidelines
The primary treatment for a mucous plug is to use guaifenesin, an expectorant that can help loosen and clear mucus from the airways, as it has been shown to increase expectorated sputum volume, decrease sputum viscosity, and improve associated symptoms 1. Here are some key points to consider:
- Guaifenesin is a water- and alcohol-soluble substance that has been used as an expectorant to loosen phlegm and bronchial secretions in the symptomatic management of cough associated with upper and lower respiratory tract infections 1.
- There is clinical evidence that guaifenesin is an effective expectorant, increasing expectorated sputum volume over the first 4 to 6 days of a productive cough, decreasing sputum viscosity and difficulty in expectoration, and improving associated symptoms 1.
- However, it is essential to note that there is currently insufficient evidence to support the efficacy of guaifenesin as an adjunct in sinusitis, as no clinical trials have been reported in sinusitis to demonstrate its efficacy 1.
- Other treatments, such as saline nasal irrigation, may also be beneficial in helping to clear mucus from the airways, but the evidence for these treatments is not as strong as it is for guaifenesin 1.
- In some cases, airway clearance techniques, such as autogenic drainage, oscillating positive expiratory pressure devices, and high-frequency chest compression devices, may be useful in helping to clear mucus from the airways, especially in patients with significant mucus production and clearance problems 1.
From the FDA Drug Label
Acetylcysteine solution, USP is indicated as adjuvant therapy for patients with abnormal, viscid, or inspissated mucous secretions in such conditions as: The mucolytic action of acetylcysteine is related to the sulfhydryl group in the molecule This group probably “opens” disulfide linkages in mucus thereby lowering the viscosity.
The treatment for a mucous plug is acetylcysteine as an adjuvant therapy to help break down the mucous secretions, specifically by lowering the viscosity of the mucus. Key points include:
- Mucolytic action: Acetylcysteine breaks down disulfide linkages in mucus.
- Indications: Acetylcysteine is used for abnormal, viscid, or inspissated mucous secretions. 2 2
From the Research
Treatment for Mucous Plugs
The treatment for mucous plugs can vary depending on the underlying condition. Some studies suggest the use of expectorants such as guaifenesin to help loosen and clear mucus from the airways 3.
- Guaifenesin is a mucoactive drug that acts by loosening mucus in the airways and making coughs more productive.
- It is used for relief of wet cough and chest congestion due to the common cold.
- Guaifenesin has a well-established and favorable safety and tolerability profile in adult and pediatric populations.
However, other studies have found that guaifenesin may not be effective in all cases, particularly in acute respiratory tract infections 4.
- A randomized, parallel-group, double-blind, placebo-controlled study found no effect of extended-release guaifenesin on mucociliary and cough clearance during an acute respiratory tract infection.
- The study found no significant difference in sputum biophysical properties after administration of guaifenesin or placebo.
In some cases, more targeted treatments may be necessary, such as dupilumab for severe eosinophilic asthma 5.
- A case study found that dupilumab improved asthma control and reduced mucus plugs in a patient with severe eosinophilic asthma.
- The study suggests that dupilumab may be an effective treatment against mucus plugs associated with severe eosinophilic asthma.
Other conditions that involve mucus plugs, such as allergic bronchopulmonary aspergillosis and plastic bronchitis, may require different treatment approaches 6, 7.
- These conditions often require a combination of medications and therapies to manage symptoms and prevent complications.
- The use of artificial intelligence-assisted image reading technology may help improve the diagnosis and management of these conditions.