Assessment and Treatment of Mucus Hypersecretion in COPD: A Case Study

Kami Whitney PA-C^1,

¹Arjun Medical Center, Gainesville, VA, USA

Cite this paper

Kami Whitney PA-C. Assessment and Treatment of Mucus Hypersecretion in COPD: A Case Study. American Journal of Medical Case Reports. 2021; 9(12):730-733. doi: 10.12691/AJMCR-9-12-18

Abstract

Mucus hypersecretion is a debilitating feature of COPD that is often overlooked and under treated by clinicians despite its contribution to declining lung function and quality of life. This case study explores the use of the COPD Assessment Test in the evaluation of mucus hypersecretion and improvements in quality of life related to this symptom after the addition of guaifenesin as part of a comprehensive COPD care plan.

Keywords

COPD, exacerbation, mucus hypersecretion, mucociliary clearance, guaifenesin, chronic bronchitis

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Yawn, Barbara, and Victor Kim. “COPD in Primary Care: Key Considerations for Optimized Management: Treatment Options for Stable Chronic Obstructive Pulmonary Disease: Current Recommendations and Unmet Needs.” J Fam Pract 67, no. 2 supplement (February 2018): S28-S37.
[2]	Tian, Pan-wen, and Fu-qiang Wen. “Clinical Significance of Airway Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease.” J Transl Int Med 3, no. 3 (2015): 89-92.
[3]	de Oca, Maria Montes, Ronald J. Halbert, Maria Victorina Lopez, Rogelio Perez-Padilla, Carlos Tálamo, Dolores Moreno, Adrianna Muiño, et al. “The Chronic Bronchitis Phenotype in Subjects with and without COPD: The Platino Study.” Eur Respir J 40, no. 1 (2012): 28-36.
[4]	Miravitlles, Marc. “Cough and Sputum Production as Risk Factors for Poor Outcomes in Patients with COPD.” Respiratory Medicine 105, no. 8 (2011): 1118-28.
[5]	Jones, Paul, Gale Harding, Ingela Wiklund, Pamela Berry, and Nancy Leidy. “Improving the Process and Outcome of Care in COPD: Development of a Standardised Assessment Tool.” Prim Care Respir J. 18, no. 3 (2009): 208-15.
[6]	Stott-Miller, Marni, Hana Müllerová, Bruce Miller, Maggie Tabberer, Céline El Baou, Tom Keeley, Fernando J Martinez, et al. “Defining Chronic Mucus Hypersecretion Using the Cat in the Spiromics Cohort.” Int J Chron Obstruct Pulmon Dis Volume 15 (2020): 2467-76.
[7]	Ohar, Jill A., James F. Donohue, and Selwyn Spangenthal. “The Role of Guaifenesin in the Management of Chronic Mucus Hypersecretion Associated with Stable Chronic Bronchitis: A Comprehensive Review.” Chronic Obstr Pulm Dis 6, no. 4 (2019): 341-49.
[8]	Storms, William W., and Judi E. Miller. “Improved Lung Function and Quality of Life Following Guaifenesin Treatment in a Patient with Chronic Obstructive Pulmonary Disease (COPD): A Case Report.” Respir Med Case Rep 24 (April 2018): 84-85.
[9]	Storms, William W., and Judi E. Miller. “Daily Use of Guaifenesin (Mucinex) in a Patient with Chronic Bronchitis and Pathologic Mucus Hypersecretion: A Case Report.” Respir Med Case Rep 23 (February 2018): 156-57.
[10]	Singer, Ethan, and Judi E. Miller. “Improved Quality of Life Associated with Long-Term Use of Guaifenesin in a Patient with Chronic Obstructive Pulmonary Disease (COPD) & Stable Chronic Bronchitis: A Case Report.” Respir Med Case Rep 26 (February 2019): 9-10.
[11]	“2021 Gold Reports - Global Initiative for Chronic Obstructive Lung Disease.” GOLD, January 8, 2021. Accessed September 14, 2021, https://goldcopd.org/2021-gold-reports/.
[12]	Roig, Juan, James Fink, and David Burchfield. “Pharmacologic Adjuncts I.” Essay. In Assisted Ventilation of the Neonate, Fifth ed., 347-70. Elsevier, 2011.
[13]	Waller DG, and Sampson AP. Medical Pharmacology and Therapeutics 2018 (Fifth Edition), Elsevier, 2018, 211-216.
[14]	Burgel, Pierre-Régis, and Clémence Martin. “Mucus Hypersecretion in COPD: Should We Only Rely on Symptoms?” Eur Respir Rev 19, no. 116 (2010): 94-96.
[15]	Albrecht, Helmut H., Peter V. Dicpinigaitis, and Eric P. Guenin. “Role of Guaifenesin in the Management of Chronic Bronchitis and Upper Respiratory Tract Infections.” Multidiscip Respir Med 12 (2017): 94-96.
[16]	Seagrave, JeanClare, Helmut Albrecht, Yong Sung Park, Bruce Rubin, Gail Solomon, and K. Chul Kim. “Effect of Guaifenesin on Mucin Production, Rheology, and Mucociliary Transport in Differentiated Human Airway Epithelial Cells.” Exp Lung Res 37, no. 10 (2011): 606-14.
[17]	Seagrave, JeanClare, Helmut H Albrecht, David B Hill, Duncan F Rogers, and Gail Solomon. “Effects of Guaifenesin, N-Acetylcysteine, and Ambroxol on MUC5AC and Mucociliary Transport in Primary Differentiated Human Tracheal-Bronchial Cells.” Respir Res 13, no. 1 (October 2012): 98.
[18]	Thomson, M. L., D. Pavia, and M. W. McNicol. “A Preliminary Study of the Effect of Guaiphenesin on Mucociliary Clearance from the Human Lung.” Thorax 28, no. 6 (1973): 742-47.
[19]	Bennett, William, Kirby Zeman, and Jihong Wu. “Effect of Oral Guaifenesin (Mucinex 1200mg) on Mucociliary Clearance from the Lungs of Healthy Non-Smoking Adults.” ERS Annual Conference, May 2010.
[20]	Robinson, R., W. B. Cummings, and E. R. Deffenbaugh. “Effectiveness of Guaifenesin as an Expectorant: a Cooperative Double-Blind Study.” Curr Ther Res 22, no. 2 (1977): 284-96.
[21]	Chodosh S. “Objective sputum changes associated with glyceryl guaiacolate in chronic bronchial diseases.” Bull Physiopathol Respir 9 (2), 452-6, Jan. 1973.
[22]	Chodosh, C. “Glyceryl Guaicolate: a Controlled Laboratory and Clinical Study.” Am Rev Respir Disease 90, no. 2 (January 1964): 258.
[23]	HAYES, EDWARD W., and Lyle S. Jacobs. “A Clinical Evaluation of the Effectiveness of Robitussin in Chronic Cough.” Chest 30, no. 4 (October 1, 1956): 441-48.
[24]	Wójcicki, J. “The Use of Duopect as Expectorant-Antitussive Agent.” Arch Immunol Ther Exp 23, no. 1 (1975): 135-42.
[25]	Finiguerra, M. “Guaifenesin in Chronic Hypersecretion Bronchopneumopathy: Double-Blind Placebo-Controlled Clinical Study.” Clin Europa 21, no. 4 (1982): 751-64.