{"id":9360,"date":"2012-05-01T18:00:00","date_gmt":"2012-05-01T18:00:00","guid":{"rendered":""},"modified":"2017-02-27T16:03:51","modified_gmt":"2017-02-27T16:03:51","slug":"kosulys-kada-verta-nerimauti-ir-kaip-gydyti","status":"publish","type":"post","link":"https:\/\/www.pasveik.lt\/lt\/naujausi-medicinos-straipsniai\/kosulys-kada-verta-nerimauti-ir-kaip-gydyti\/9360\/","title":{"rendered":"Kosulys: kada verta nerimauti ir kaip gydyti"},"content":{"rendered":"<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> \u2013 tai bes\u0105lyginiu refleksu paremtas apsauginis organizmo atsakas \u012f kv\u0117pavimo tak\u0173 (nosies ertm\u0117s, gerkl\u0173, trach\u0117jos, bronch\u0173) dirginim\u0105, siekiant pa\u0161alinti i\u0161 j\u0173 svetimk\u016bn\u012f ar kitok\u012f \u017ealing\u0105 dirgikl\u012f. Kosul\u012f gali sukelti ne tik kv\u0117pavimo tak\u0173, bet ir kr\u016btinpl\u0117v\u0117s (pleuros), \u0161iuos organus inervuojan\u010di\u0173 nerv\u0173 \u0161akneli\u0173 ar paties kv\u0117pavimo centro, esan\u010dio galvos smegenyse, dirginimas. Kosint i\u0161 kv\u0117pavimo tak\u0173 kartu su stipriai suspausto oro srove pa\u0161alinami \u012fvair\u016bs dirgikliai \u2013 dulk\u0117s, gleiv\u0117s, p\u016bliai, skrepliai, mikroorganizmai, kraujo kre\u0161uliai ir kt.<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Pagal trukm\u0119 <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> skiriamas \u012f \u016bmin\u012f (trunkant\u012f iki 8 savai\u010di\u0173) ir l\u0117tin\u012f (8 sav. arba ilgiau). Ilgiau besit\u0119siantis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> gali b\u016bti sunkios ligos po\u017eymis, tod\u0117l visuomet tur\u0117t\u0173 b\u016bti vertinamas labai rimtai. L\u0117tinis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> sutrikdo mieg\u0105, ma\u017eina darbingum\u0105, kartais sunkina bendravim\u0105 ir blogina gyvenimo kokyb\u0119. Labai stiprus <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> gali refleksi\u0161kai i\u0161provokuoti v\u0117mim\u0105, sukelti galvos, kr\u016btin\u0117s l\u0105stos skausm\u0105, net \u0161onkauli\u0173 l\u016b\u017eim\u0105. Moter\u0173 kosulio refleksas yra jautresnis nei vyr\u0173, tod\u0117l moterys grei\u010diau \u201eu\u017esikosti\u201c, joms <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> labiau link\u0119s virsti l\u0117tiniu.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Klini\u0161kai <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> skiriamas \u012f:<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l3 level1 lfo2; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">saus\u0105, neproduktyv\u0173 (jei ligonis nieko neatkosti) ir<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l3 level1 lfo2; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">dr\u0117gn\u0105, produktyv\u0173 (atkosima pilk\u0161vai balt\u0173 ar skaidri\u0173, gelsv\u0173 ar \u017ealsv\u0173 p\u016bling\u0173 skrepli\u0173). <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Pirmosiomis \u016bmini\u0173 virusini\u0173 infekcij\u0173 dienomis d\u0117l kv\u0117pavimo tak\u0173 u\u017edegimo ir hiperemijos sutrinka bronch\u0173 liauku\u010di\u0173 veikla, slopinama gleivi\u0173 gamyba, tod\u0117l ligon\u012f vargina sausas neproduktyvus <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a>. Po 4\u20135 dien\u0173 liauku\u010di\u0173 veikla suaktyv\u0117ja, pradedama gaminti daugiau sekreto, ir <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> palengv\u0117ja. I\u0161 prad\u017ei\u0173 skrepliai b\u016bna pilk\u0161vi, gleivingi, v\u0117liau \u2013 gelsvi ar \u017ealsvi, tai rodo prisid\u0117jusi\u0105 banalin\u0119 bakterin\u0119 infekcij\u0105. Prad\u0117jus atkos\u0117ti skrepli\u0173, paciento b\u016bkl\u0117 pager\u0117ja, nes dr\u0117gnas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> lengviau pakeliamas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Diagnostika<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> n\u0117ra liga, o tik kokios nors ligos simptomas, tod\u0117l visada reikia i\u0161siai\u0161kinti kosulio prie\u017east\u012f ir tik po to parinkti gydym\u0105. Da\u017enai kosulio, ypa\u010d \u016bminio, prie\u017eastis b\u016bna akivaizdi: per\u0161alimas, \u016bmin\u0117s infekcijos po\u017eymiai, astmos, l\u0117tinio bronchito ar kitos ligos anamnez\u0117. U\u017etruk\u0119s neai\u0161kios kilm\u0117s <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a>, ypa\u010d lydimas vadinam\u0173j\u0173 aliarmo po\u017eymi\u0173 (sunk\u0117janti ligonio b\u016bkl\u0117, ry\u0161k\u0117jantis silpnumas, intoksikacija, k\u016bno svorio kritimas, kraujo atkos\u0117jimas ir kt.) ver\u010dia \u012ftarti kosul\u012f suk\u0117lusi\u0105 sunki\u0105 lig\u0105 \u2013 piktybin\u012f navik\u0105 (plau\u010di\u0173 ar metastazin\u012f), tuberkulioz\u0119 ar kt. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Kosul\u012f suk\u0117lusi prie\u017eastis (liga) diagnozuojama \u012fvertinus ligonio nusiskundimus ir j\u0173 dinamik\u0105, raid\u0105 (stabil\u016bs ar progresuoja, sunk\u0117ja), anamnez\u0119, objektyvius po\u017eymius (auskultacijos, perkusijos, sukusijos). Diagnozei nustatyti ar patikslinti atliekami instrumentiniai ir vaizdo radiologiniai tyrimai: kr\u016btin\u0117s l\u0105stos rentgenografija, kompiuterin\u0117 tomografija, angiografija, bronchoskopija, mikrobiologi\u0161kai ir citologi\u0161kai tiriami skrepliai, kv\u0117pavimo tak\u0173 sekretas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Prie\u017eastys<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Da\u017eniausia kosulio prie\u017eastis \u2013 \u016bmin\u0117s ir l\u0117tin\u0117s kv\u0117pavimo tak\u0173 infekcijos. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u016aminis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a><\/span><\/i><\/b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"> <\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Da\u017eniausiai \u016bmin\u012f kosul\u012f sukelia vadinamosios per\u0161alimo ligos. Per 80 proc. j\u0173 yra virusin\u0117s kilm\u0117s, re\u010diau \u2013 bakterin\u0117s, sukeltos streptokok\u0173, <i>Hemophilus influenzae<\/i>, mikoplazm\u0173 ir kt. \u016amin\u012f kosul\u012f gali sukelti alergija (rinitas, tracheitas, bronchitas), kv\u0117pavimo tak\u0173 sudirginimas oro ter\u0161alais (dulk\u0117mis, d\u016bmais, cheminiais aerozoliais ir kt.), \u012f kv\u0117pavimo takus kv\u0117puojant ar valgant patek\u0119s svetimk\u016bnis ir kt.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">L\u0117tinis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> <\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">L\u0117tiniu vadinamas ilgiau nei 2 m\u0117nesius trunkantis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a>. J\u012f da\u017eniausiai sukelia l\u0117tin\u0117s, nepakankamai efektyviai gydomos kv\u0117pavimo organ\u0173 ligos: <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bronchu-astma\/4344\">bronch\u0173 astma<\/a>, l\u0117tine obstrukcin\u0117 plau\u010di\u0173 liga, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/tuberkulioze\/4450\">tuberkulioz\u0117<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bronchektazes\/72325\">bronchektaz\u0117s<\/a>. Ilgai trunkant\u012f kosul\u012f gali sukelti \u012fvairios kitos prie\u017eastys: mechanin\u0117s (trach\u0117j\u0105 ar bronchus i\u0161 i\u0161or\u0117s spaud\u017eiantys navikai, padid\u0117jusi skydliauk\u0117, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/aortos-aneurizma\/4340\">aortos aneurizma<\/a> ar i\u0161sipl\u0117timas), skrand\u017eio turinio atpylimas \u012f stempl\u0119 ir po to \u012f kv\u0117pavimo takus, auk\u0161ta diafragmos pad\u0117tis d\u0117l pilvapl\u0117v\u0117s ertm\u0117je susikaupusio skys\u010dio, meteorizmo, chemin\u0117s med\u017eiagos, dirginan\u010dios kv\u0117pavimo takus (chloras, acetonas, dulk\u0117s, tabako d\u016bmai ir kt.), kv\u0117pavimo tak\u0173 navikai, \u0161irdies ir kraujagysli\u0173 ligos, d\u0117l kuri\u0173 did\u0117ja kraujo sl\u0117gis plau\u010diuose ir ma\u017eajame kraujo apytakos rate, D vitamino tr\u016bkumas ir <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/hipokalcemija\/72703\">hipokalcemija<\/a>, d\u0117l kuri\u0173 galimas gerkl\u0173 susiaur\u0117jimas, AKF inhibitori\u0173, beta adrenoblokatori\u0173 ar kai kuri\u0173 kit\u0173 vaist\u0173 vartojimas, nerv\u0173 ir psichikos ligos (isterinis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a>, rijim\u0105 kontroliuojan\u010di\u0173 nerv\u0173 paraly\u017eius ir kt.). <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Gan da\u017ena u\u017esit\u0119susio kosulio prie\u017eastis \u2013 rinosinusitas, kai i\u0161 sinus\u0173 nutekantis u\u017edegiminis sekretas dirgina kv\u0117pavimo takus ir sukelia \u012fkyr\u0173 kosul\u012f. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Klinika<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Epizodinis sukos\u0117jimas yra normalus rei\u0161kinys, padedantis kv\u0117pavimo takams apsivalyti nuo dulki\u0173, gleivi\u0173, svetimk\u016bni\u0173. U\u017esit\u0119s\u0119s <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> vargina, sutrikdo mieg\u0105, poils\u012f, ma\u017eina darbingum\u0105, blogina gyvenimo kokyb\u0119. L\u0117tinis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> gali sukelti galvos skausm\u0105, svaigim\u0105, gaus\u0173 prakaitavim\u0105, nevaling\u0105 pasi\u0161lapinim\u0105, sunkiais atvejais \u2013 \u0161onkauli\u0173 l\u016b\u017eim\u0105 (da\u017eniau \u012fvyksta osteoporoze sergan\u010dioms moterims).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Gydymas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">Kosulys<\/a> yra nat\u016bralus apsauginis refleksas, padedantis kv\u0117pavimo takams \u201eapsiginti\u201c ir i\u0161sivalyti nuo patogen\u0173, svetimk\u016bni\u0173, alergen\u0173, chemini\u0173 ter\u0161al\u0173 ir pan. Jei tik \u012fmanoma, kosulio nereikia slopinti: saus\u0105 neproduktyv\u0173 kosul\u012f stengiamasi \u201epaversti\u201c dr\u0117gnu, produktyviu. Dr\u0117gnas <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a> ne tik lengviau pakeliamas, ma\u017eiau vargina, bet ir biologiniu po\u017ei\u016briu yra pageidaujamas, nes i\u0161valo kv\u0117pavimo takus ir net gali pa\u0161alinti pa\u010di\u0105 kosul\u012f suk\u0117lusi\u0105 prie\u017east\u012f, pavyzd\u017eiui, svetimk\u016bn\u012f, alergenus, gleivi\u0173 sankaup\u0105. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Slopinamas tik sausas, \u012fkyrus, ligon\u012f varginantis <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/kosulys\/56468\">kosulys<\/a>, kur\u012f suk\u0117lusios prie\u017easties nepavyksta ar ne\u012fmanoma pa\u0161alinti (pavyzd\u017eiui, i\u0161operuoti progresuojan\u010dio naviko). <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Veiksmingiausias kosulio nuslopinimo b\u016bdas \u2013 kosul\u012f suk\u0117lusios ligos (astmos, plau\u010di\u0173 u\u017edegimo, bronchito ar kt.) i\u0161gydymas ar valdymas: sergantiesiems <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/plauciu-uzdegimas-pneumonija\/72052\/\">plau\u010di\u0173 u\u017edegimu<\/a>\u00a0ar tuberkulioze skiriama veiksming\u0173 antibiotik\u0173, astma \u2013 inhaliacini\u0173 gliukokortikoid\u0173 ir bronchodilatatori\u0173 ir pan. Kartu su etiotropiniu (prie\u017eastiniu) gydymu rekomenduojamos ir simptomi\u0161kai kosul\u012f veikian\u010dios priemon\u0117s, lengvinan\u010dios kosul\u012f, gerinan\u010dios atkos\u0117jim\u0105. Pastaraisiais metais atlikti klinikiniai tyrimai \u012frod\u0117, kad \u0161ios simptomin\u0117s priemon\u0117s neturi reik\u0161mingos \u012ftakos kv\u0117pavimo lig\u0173 raidai ir trukmei, ta\u010diau jos gali palengvinti subjektyvi\u0105 paciento b\u016bkl\u0119, pagerinti savijaut\u0105 ir gyvenimo kokyb\u0119.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Kosuliui palengvinti tradici\u0161kai naudojamos liaudies medicinos priemon\u0117s \u2013 vaisting\u0173j\u0173 \u017eoleli\u0173 \u017eied\u0173, s\u0117kl\u0173 ar \u0161akn\u0173 nuovirai, u\u017epilai, i\u0161traukos. Da\u017eniausiai vartojama \u010diobreli\u0173 \u017eol\u0117, \u0161alpusni\u0173, na\u0161lai\u010di\u0173 (<i>Viola tricolor<\/i>), did\u017eia\u017eied\u017ei\u0173 tubi\u0173 \u017eiedai. Kosul\u012f slopina ir mink\u0161tina mork\u0173, ridik\u0173 sultys (jei pacientas nealergi\u0161kas, geriama su liep\u0173 ar pu\u0161\u0173 medumi), pasaldintos kop\u016bst\u0173 sultys, alijo\u0161iaus ar \u010desnako ir medaus mi\u0161inys. Kosintiems vaikams prie\u0161 mieg\u0105 rekomenduojamos garsty\u010di\u0173 vonel\u0117s kojoms.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Augalin\u0117s kilm\u0117s vaist\u0173 poveikis kosuliui n\u0117ra \u012frodytas patikimais moksliniais tyrimais, tod\u0117l augaliniai preparatai n\u0117ra rekomenduojami ekspert\u0173 sutarim\u0173 (gairi\u0173) kaip kosul\u012f raminan\u010dios ar lengvinan\u010dios priemon\u0117s.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Dauguma \u016bmini\u0173 ir l\u0117tini\u0173 (ypa\u010d pa\u016bm\u0117jusi\u0173) kv\u0117pavimo tak\u0173 lig\u0173, kaip antai \u016bminis ir l\u0117tinis bronchitas, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/letine-obstrukcine-plauciu-liga\/4463\">l\u0117tin\u0117 obstrukcin\u0117 plau\u010di\u0173 liga<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bronchu-astma\/4344\">bronch\u0173 astma<\/a>, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/cistine-fibroze\/72664\">cistin\u0117 fibroz\u0117<\/a>, bronchektazin\u0117 liga, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/tuberkulioze\/4450\">tuberkulioz\u0117<\/a> ir kt., pasirei\u0161kia sustipr\u0117jusia bronch\u0173 gleivi\u0173 sekrecija. Pradiniu \u0161i\u0173 lig\u0173 periodu gleivi\u0173 sekrecija da\u017eniausiai b\u016bna nedidel\u0117, v\u0117liau stipr\u0117ja, sukeldama kosul\u012f, skrepliavim\u0105, respiracin\u012f diskomfort\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Subjektyvi ligonio savijauta labai priklauso nuo gleivi\u0173 klampumo, vadinamojo viskoziteto: jei gleiv\u0117s skystokos, ligonis j\u0173 atkosti lengvai, bendra b\u016bkl\u0117 i\u0161lieka nebloga; jei gleiv\u0117s tir\u0161tos ir klampios, ligoniui sunku atkos\u0117ti, gleiv\u0117s kem\u0161a kv\u0117pavimo takus, gali sukelti arba pasunkinti jau esan\u010di\u0105 bronch\u0173 obstrukcij\u0105. Kv\u0117pavimo takuose besikaupian\u010dios gleiv\u0117s yra gera terp\u0117 patogeniniams mikroorganizmams daugintis, sudaro prielaidas infekcijai progresuoti, komplikacijoms atsirasti, apsunkina gydym\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Tad, gydant \u016bmines ar l\u0117tines kv\u0117pavimo organ\u0173 ligas, svarbus vaidmuo tenka gleivi\u0173 sekrecij\u0105, j\u0173 fizikines ir chemines savybes koreguojantiems vaistams. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u0160ie vaistai:<\/span><\/i><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l0 level1 lfo3; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">skatina arba slopina kv\u0117pavimo tak\u0173 gleivi\u0173 gamyb\u0105;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l0 level1 lfo3; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">kei\u010dia gleivi\u0173 sud\u0117t\u012f;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l0 level1 lfo3; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">aktyvina gleivi\u0173 s\u0105veik\u0105 su kv\u0117pavimo tak\u0173 virpamuoju epiteliu, pagerina virpamojo epitelio klirens\u0105, t. y. transportin\u0119 \u2013 mukociliarin\u0119 funkcij\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Vienas pla\u010diausiai klinikin\u0117je praktikoje vartojam\u0173 vaist\u0173, veikian\u010di\u0173 kv\u0117pavimo tak\u0173 gleivi\u0173 funkcij\u0105, yra ambroksolis \u2013 a\u0161tuntasis veiklusis bromheksino metabolitas. Ambroksolis aktyviai veikia kv\u0117pavimo tak\u0173 gleives, stimuliuoja epitelio mukociliarin\u012f klirens\u0105, skatina u\u017edegiminio sekreto, patogen\u0173, svetimk\u016bni\u0173 pasi\u0161alinim\u0105 i\u0161 trach\u0117jos ir bronch\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Klinikiniai tyrimai ir medicinos praktika \u012frodo, kad ambroksolis gali reik\u0161mingai pagerinti sergan\u010di\u0173j\u0173 \u016bmin\u0117mis ir l\u0117tin\u0117mis kv\u0117pavimo tak\u0173 ligomis subjektyvi\u0105 b\u016bkl\u0119 ir savijaut\u0105 bei gyvenimo kokyb\u0119.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Daugeliu mokslini\u0173 klinikini\u0173 tyrim\u0173 \u012frodytas ambroksolio veiksmingumas gydant \u012fvairias ligas, pasirei\u0161kian\u010dias kv\u0117pavimo tak\u0173 gleivi\u0173 hipersekrecija, net ir tokias sunkias, progresuojan\u010dias, kaip <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/letine-obstrukcine-plauciu-liga\/4463\">l\u0117tin\u0117 obstrukcin\u0117 plau\u010di\u0173 liga<\/a> (LOPL). \u012erodytas ir prevencinis ambroksolio veikimas: pavyzd\u017eiui, nustatyta, kad vartojant \u0161io vaisto galima suma\u017einti l\u0117tinio bronchito pa\u016bm\u0117jim\u0173 da\u017en\u012f.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u012erodytas palankus ambroksolio poveikis sergantiesiems cistine fibroze, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/bronchu-astma\/4344\">bronch\u0173 astma<\/a> ir bronchospazminiu (obstrukciniu) bronchitu, taip pat naujagimi\u0173 hialino membran\u0173 sindromo prevencijai bei gydymui. Nustatytas ambroksolio veiksmingumas kompleksi\u0161kai gydant plau\u010di\u0173 alveoli\u0173 proteinoz\u0119.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis racionaliai dera su kitais kv\u0117pavimo ligoms gydyti vartojamais vaistais \u2013 antibiotikais, imunomoduliatoriais, bronchodilatatoriais, gliukokortikoidais, antialerginiais. Pavyzd\u017eiui, ambroksolio rekomenduojama skirti kartu su antioksidantais pacientams po kr\u016btin\u0117s l\u0105stos operacij\u0173, siekiant apsaugoti juos nuo bronch\u0173 ir plau\u010di\u0173 komplikacij\u0173.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><span style=\"mso-spacerun: yes;\">\u00a0<\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Poveikio mechanizmas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis veikia prakti\u0161kai visus svarbiausius kosulio patofiziologijos mechanizmus:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">skystina gleives ir padeda jas pa\u0161alinti i\u0161 kv\u0117pavimo tak\u0173, gerindamas kv\u0117pavimo tak\u0173 virpamojo epitelio funkcij\u0105 (mukociliarin\u012f klirens\u0105);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">slopina gleivin\u0117s u\u017edegim\u0105 (u\u017edegimo mediatori\u0173 citokin\u0173, leukotrien\u0173, histamino gamyb\u0105 ir i\u0161skyrim\u0105), pasi\u017eymi antioksidaciniu veikimu; slopina Na<sup>+<\/sup> kanalus ir skausmo signal\u0173 plitim\u0105 jais);<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">pagerina antibiotik\u0173 patekim\u0105 \u012f bronch\u0173 ir plau\u010di\u0173 audin\u012f;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">gerina plau\u010di\u0173 funkcij\u0105;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">skatina surfaktanto sintez\u0119;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l4 level1 lfo4; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">sukelia saiking\u0105 bronchodilatacij\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis greitai ir veiksmingai palengvina kosul\u012f, veikdamas dvejopu mechanizmu: <\/span><\/i><\/p>\n<ul style=\"margin-top: 0cm;\">\n<li class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">skystindamas kv\u0117pavimo takuose susikaupusias gleives ir skatindamas j\u0173 transport\u0105, palengvindamas atkos\u0117jim\u0105;<\/span><\/li>\n<li class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt; mso-list: l2 level1 lfo1; tab-stops: list 36.0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">suma\u017eina kosulio intensyvum\u0105, pagerina mieg\u0105 ir paciento gyvenimo kokyb\u0119.<\/span><\/li>\n<\/ul>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Kitaip nei acetilcisteinas, kuris gali netgi suma\u017einti kai kuri\u0173 antibakterini\u0173 vaist\u0173 aktyvum\u0105, ambroksolis gerina antibiotik\u0173 patekim\u0105 \u012f plau\u010dius, didina antibiotikoterapijos veiksmingum\u0105, suma\u017eina komplikacij\u0173 rizik\u0105. Unikali ambroksolio savyb\u0117 yra ta, kad jis padidina antibiotik\u0173 kiek\u012f plau\u010di\u0173 audinyje ir gleiv\u0117se. Klinikiniais tyrimais \u012frodytas mukokinetinis ir mukolizinis ambroksolio poveikis. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Mukokinetinis poveikis<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Eksperimenti\u0161kai nustatyta, kad ambroksolis priklausomai nuo doz\u0117s reik\u0161mingai padidina anestezuot\u0173 triu\u0161i\u0173 ir j\u016bros kiauly\u010di\u0173 bronch\u0173 sekrecij\u0105 ir kv\u0117pavimo tak\u0173 sekreto kiek\u012f iki 9 val. laikotarpiu po vaisto pavartojimo. Skiriamas \u012f trach\u0117j\u0105 ambroksolis skatina gleivi\u0173 glikoprotein\u0173 gamyb\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Poveikis kv\u0117pavimo tak\u0173 virpamajam epiteliui<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Nustatyta, kad ambroksolis skatina kv\u0117pavimo tak\u0173 gleivin\u0117s funkcin\u012f aktyvum\u0105, padidina virpamojo epitelio plaukeli\u0173 virpesi\u0173 koordinuot\u0173 judesi\u0173 da\u017en\u012f ir kv\u0117pavimo takuose esan\u010di\u0173 kiet\u0173j\u0173 daleli\u0173 transporto greit\u012f (pa\u0161alinim\u0105).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Poveikis surfaktanto sistemai<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Kitus mukolitikus ambroksolis pranoksta didesne terapine platuma. Ambroksolis stimuliuoja plau\u010di\u0173 surfaktanto sistem\u0105, tod\u0117l suma\u017e\u0117ja alveoli\u0173 ir bronch\u0173 gleivin\u0117s kibumas, u\u017edegiminiam sekretui sunkiau prikibti prie bronch\u0173 sieneli\u0173, palengv\u0117ja gleivi\u0173 atkos\u0117jimas ir pa\u0161alinimas i\u0161 kv\u0117pavimo tak\u0173. \u012erodyta, kad ambroksolis skatina surfaktanto gamyb\u0105 II tipo alveoli\u0173 l\u0105stel\u0117se.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Tyr\u0117jai nurodo, kad padid\u0117j\u0119s surfaktanto kiekis gali b\u016bti vienas svarbi\u0173 apsaugos nuo A tipo gripo viruso infekcijos veiksni\u0173 ir \u0161\u012f proces\u0105 stimuliuoja ambroksolis.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Antioksidacinis ir u\u017edegim\u0105 slopinantis poveikis<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u012erodyta, kad ambroksolis: slopina u\u017edegim\u0105 ir laisv\u0173j\u0173 deguonies radikal\u0173 susidarym\u0105, saugo nuo \u017ealingo oksidacinio streso, sukeliamo laisv\u0173j\u0173 radikal\u0173, esan\u010di\u0173 tabako d\u016bmuose, bei u\u017edegimini\u0173 l\u0105steli\u0173, kaip antai neutrofil\u0173 ir alveol\u0117se esan\u010di\u0173 makrofag\u0173, poveikio. Ambroksolis apsaugo nuo citotoksini\u0173 preparat\u0173 (pvz., doksorubicino) sukeliamos lipid\u0173 peroksidacijos.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">U\u017edegim\u0105 slopinan\u010dios ambroksolio savyb\u0117s buvo nustatytos tyrimais su neutrofilais, makrofagais ir putliosiomis l\u0105stel\u0117mis. Patvirtinta, kad ambroksolis slopina superoksido anijon\u0173 ir hipochloro r\u016bg\u0161ties (HOCl) sintez\u0119, stabdo pirmini\u0173 granuli\u0173, turin\u010di\u0173 elastaz\u0117s ir mieloperoksidaz\u0117s, egzocitoz\u0119, apsaugo alfa-1 antitripsin\u0105 nuo neutrofil\u0173 inaktyvacijos, skatina antiproteaz\u0119 sujungti ir inaktyvuoti elastaz\u0119. Tai rodo, kad ambroksolis gali stabdyti netgi LOPL progresavim\u0105. Nustatyta, kad ambroksolio poveikis ry\u0161kesnis sunkesne LOPL forma sergantiems pacientams, jiems \u0161is vaistas patikimai labiau atitolino LOPL pa\u016bm\u0117jimus ir suma\u017eino pa\u016bm\u0117jim\u0173 da\u017enum\u0105. Tai rodo, kad palankus ambroksolio poveikis ry\u0161kesnis sunkesne LOPL forma sergantiems, labiau kosintiems ir sunkiau atkosintiems asmenims, palyginti su lengva ligos forma sergan\u010diais pacientais.<span style=\"mso-spacerun: yes;\">\u00a0\u00a0 <\/span><\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis reik\u0161mingai suma\u017eina histamino ir augimo faktoriaus i\u0161skyrim\u0105 i\u0161 \u017emoni\u0173 putli\u0173j\u0173 l\u0105steli\u0173 bei monocit\u0173, esan\u010di\u0173 plau\u010diuose, odoje ir \u017earnyne. \u0160ios l\u0105stel\u0117s aktyviai dalyvauja greito tipo padid\u0117jusio jautrumo reakcij\u0173 \u016bmin\u0117je faz\u0117je. Histaminas skatina lygi\u0173j\u0173 raumen\u0173 susitraukim\u0105, kraujagysli\u0173 i\u0161sipl\u0117tim\u0105 ir didina kraujagysli\u0173 sieneli\u0173 laidum\u0105. Ambroksolis ma\u017eina bronch\u0173 jaudrum\u0105 ir spazm\u0105, slopindamas histamino i\u0161skyrim\u0105 ir leukotrien\u0173 (citokin\u0173) sintez\u0119. \u012erodytas apsauginis ambroksolio poveikis plau\u010di\u0173 l\u0105stel\u0117ms.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Galimas net ir saikingas nespecifinis ambroksolio poveikis gripo virusui: eksperimentiniame modelyje su pel\u0117mis \u0161is vaistas slopino gripo viruso dauginim\u0105si kv\u0117pavimo tak\u0173 sekrete ir pailgino gripo A virusu u\u017ekr\u0117st\u0173 peli\u0173 i\u0161gyvenamum\u0105.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Vietinis skausm\u0105 mal\u0161inamasis poveikis<\/span><\/i><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Vietinis skausm\u0105 mal\u0161inamasis ambroksolio poveikis pirm\u0105 kart\u0105 buvo apra\u0161ytas 1977 m., ta\u010diau tik neseniai nustatyta, kad analgezinis ambroksolio veikimas susij\u0119s su neuron\u0173 potencialo atidarom\u0173 natrio (Na<sup>+<\/sup>) kanal\u0173 ir skausmo impuls\u0173 plitimo slopinimu. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Tyrimais nustatyta, kad ambroksolio pastil\u0117s statisti\u0161kai patikimai aktyviau slopino gerkl\u0117s skausm\u0105 nei placebas, analgezinis poveikis truko iki 3 val. po suvartojimo. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Vokietijoje atliktas tyrimas parod\u0117, kad ambroksolio sirupas nuo kosulio pasi\u017eymi daugeliu palanki\u0173 efekt\u0173, kurie neb\u016btinai<span style=\"mso-spacerun: yes;\">\u00a0 <\/span>sietini su gleivin\u0119 veikian\u010dia med\u017eiaga: ma\u017eina kosulio sukeliam\u0105 gerkl\u0117s sudirginim\u0105 (43 proc.), atskir\u0173 gerkl\u0117s viet\u0173 sudirginim\u0105 (15 proc.) ar slopina gerkl\u0117s skausm\u0105 bei per\u0161\u0117jim\u0105 (28 proc.).<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Saugumas<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolis klinikin\u0117je praktikoje vartojamas nuo 1973 m. \u0160io universalaus poveikio vaisto saugumas pagr\u012fstas daugiau 100 klinikini\u0173 tyrim\u0173, kuriuose dalyvavo per 15 t\u016bkst. pacient\u0173. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Gydant ambroksoliu retai pasitaiko nepageidaujam\u0173 \u0161alutini\u0173 poveiki\u0173, o pasitaikantys da\u017eniausiai b\u016bna lengvi, klini\u0161kai nereik\u0161mingi: neintensyvus odos b\u0117rimas, lengvas \u0161leik\u0161tulys, epigastriumo maudimas, <a href=\"https:\/\/pasveik.lt\/lt\/ligos-ir-sindromai\/dispepsija\/4503\">dispepsija<\/a>.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Ambroksolio saugumas i\u0161samiai tirtas ir pastaraisiais metais. Da\u017eniausiai ambroksol\u012f gerai toleruoja ir suaugusieji, ir vaikai. <\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><b><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Vaisto forma<\/span><\/b><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Lietuvos vaistin\u0117se prekiaujama vienu populiariausi\u0173 ambroksolio hidrochlorido preparat\u0173 Europoje \u2013 <i><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Flavamed\">Flavamed<\/a><\/i>.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Flavamed\">Flavamed<\/a><\/span><\/i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"> gaminamas keli\u0173 farmacini\u0173 form\u0173:<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l1 level1 lfo5; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/&quot;http:\/www.pasveik.lt\/lt\/vaistai\/flavamed\/10335\/\">Flavamed 60 mg<\/a> <\/span><\/i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">vy\u0161ni\u0173 skonio \u0161nyp\u0161\u010diamosios tablet\u0117s;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l1 level1 lfo5; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Flavamed\">Flavamed<\/a><\/span><\/i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"> 30 mg \u012fprastin\u0117s tablet\u0117s;<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; text-indent: -18pt; margin: 0cm 0cm 0pt 21.75pt; mso-list: l1 level1 lfo5; tab-stops: list 21.75pt;\"><span style=\"line-height: 150%; font-family: Symbol; font-size: 10pt; mso-fareast-font-family: Symbol; mso-bidi-font-family: Symbol;\"><span style=\"mso-list: Ignore;\">\u00b7<span style=\"font: 7pt 'Times New Roman';\">\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 <\/span><\/span><\/span><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"><a href=\"https:\/\/pasveik.lt\/vaistai-paieska\/?srch=Flavamed\">Flavamed<\/a><\/span><\/i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\"> 30 mg\/5 ml sirupas.<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">\u00a0<\/span><\/p>\n<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Pareng\u0117 gyd. J. Kastys <\/span><\/i><\/p>\n<p>\u017durnalas &#8222;Farmacija ir laikas&#8221;<\/p>\n","protected":false},"excerpt":{"rendered":"<p class=\"MsoNormal\" style=\"text-align: justify; line-height: 150%; margin: 0cm 0cm 0pt;\"><i><span style=\"line-height: 150%; font-family: Arial; font-size: 10pt;\">Kosulys \u2013 tai bes\u0105lyginiu refleksu paremtas apsauginis organizmo atsakas \u012f kv\u0117pavimo tak\u0173 (nosies ertm\u0117s, gerkl\u0173, trach\u0117jos, bronch\u0173) dirginim\u0105, siekiant pa\u0161alinti i\u0161 j\u0173 svetimk\u016bn\u012f ar kitok\u012f \u017ealing\u0105 dirgikl\u012f. Kosul\u012f gali sukelti ne tik kv\u0117pavimo tak\u0173, bet ir kr\u016btinpl\u0117v\u0117s (pleuros), \u0161iuos organus inervuojan\u010di\u0173 nerv\u0173 \u0161akneli\u0173 ar paties kv\u0117pavimo centro, esan\u010dio galvos smegenyse, dirginimas. Kosint i\u0161 kv\u0117pavimo tak\u0173 kartu su stipriai suspausto oro srove pa\u0161alinami \u012fvair\u016bs dirgikliai \u2013 dulk\u0117s, gleiv\u0117s, p\u016bliai, skrepliai, mikroorganizmai, kraujo kre\u0161uliai ir kt.<\/span><\/i><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[27313],"tags":[174,6767,8054,517,24646,137,2145,1562,64,7882,138],"site":[],"post_item_type":[27345],"class_list":["post-9360","post","type-post","status-publish","format-standard","hentry","category-gydymo-naujienos","tag-alergija","tag-bukle","tag-gleives","tag-kosulys","tag-kosulys-kosulys","tag-ligonis","tag-sekretas","tag-skrepliai","tag-tabletes","tag-tuberkulioze","tag-vaistai"],"acf":{"post_sites":false},"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/9360","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/comments?post=9360"}],"version-history":[{"count":0,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/posts\/9360\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/media?parent=9360"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/categories?post=9360"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/tags?post=9360"},{"taxonomy":"site","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/site?post=9360"},{"taxonomy":"post_item_type","embeddable":true,"href":"https:\/\/www.pasveik.lt\/lt\/wp-json\/wp\/v2\/post_item_type?post=9360"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}