N-AcetylCysteine, Hypertonic Saline and Mannitol in Chronic Respiratory Diseases; Efficiency and Safety Considerations

Chronic Respiratory Diseases (CRDs) are a group of long-lasting malfunctions of respiratory system. Almost all of them, are not curable and pharmacological interventions are life-time. Because of the chronic use of therapies, safety of the interventions are as important as efficacy of them. According to the guidelines of therapy, inhaled corticosteroids, inhaled beta2-agonists, methylxanthines and phosphodiesterase inhibitors are main current agents for the treatment of CRDs, while there exists a wide range of adverse reactions during long-time use of the drugs. Adding efficient agents with less side effects could be beneficial. In this article we review the efficacy and safety profile of N-AcetylCysteine, Hypertonic Saline and Mannitol on different types of CRDs, and recommend their use in the management of CRDs.

Methods: All information was collected from articles of international medical journals and online databases using key words below. PubMed, Cochrane library, Scopus, Google Scholar, and Clinicaltrial.gov databases were searched for literature published between January 2000 and December 2015.

Conclusion: Adding these agents to first line of therapy for CRDs could be beneficial, while more studies are needed to support their use in clinical setting.