Ambroxol - Uses, mechanism of action. Most popular cough medication?

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Ambroxol is a cough medication, which is successfully used in more then 50 countries, for more then 30 years.
Ambroxol is considered as mucolytic and expectorant drug. Which means, the drug breaks up phlegm, during bronchopulmonary diseases associated with abnormal mucus secretion and impaired mucus transport.
Ambroxol promotes mucus clearance, facilitates expectoration and eases productive cough.
Eventually patient breathes freely and deeply.
Ambroxol indications include:
All forms of bronchitis and tracheobronchitis, emphysema, chronic inflammatory pulmonary conditions, bronchiectasis, bronchitis with bronchospasm asthma. During acute exacerbations of bronchitis it should be given with the appropriate antibiotic.

Ambroxol starts working about 30 minutes after it has been taken. The breakdown of acid mucopolysaccharide fibers makes the sputum thinner and less viscous and therefore more easily removed by coughing.
Although sputum volume eventually decreases, its viscosity remains low for as long as treatment is maintained.

Ambroxol is shown to exert several activities: 1) secretolytic activity (i.e., promotes mucus clearance, facilitates expectoration, and eases productive cough); 2) anti-inflammatory and antioxidant activity; and 3) a local anaesthetic effect through sodium channel blocking at the level of the cell membrane.
Ambroxol stimulates synthesis and release of surfactant by type II pneumocytes, a complex mechanism that is not yet fully understood. Surfactants acts as an anti-glue factor by reducing the adhesion of mucus to the bronchial wall, in improving its transport and in providing protection against infection and irritating agents.
Additionally, due to an increased number of substances that suppress viral replication and affect bacterial biofilm structures, including immunoglobulins A and G, ambroxol has also been associated with a protective effect against viral and bacterial airway infections. Ambroxol is also believed to act synergistically with antibiotics by increasing the concentration of antibiotics in the lungs when co-administered.
most Adverse Effects reported were mild and self limiting, such as insomnia, cutaneous rash, vomiting and abdominal pain.
Ambroxol is currently not approved for prescription or over the counter use by the U.S. Food and Drug Administration (FDA) for any indication, at this time.
By BruceBlaus - Own work, CC BY-SA 4.0, https://commons.wikimedia.org/....w/index.php?curid=44

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