Pharmacologic agents to promote mucus clearance may reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of pharmacologic agents for mucus clearance in hospitalized or postoperative subjects without cystic fibrosis and over 12 months of age. We searched MEDLINE and other databases from January 1970 to July 2014 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes and assigned overall quality ratings. The 9 studies meeting review criteria included 5 randomized controlled trials, 3 crossover randomized controlled trials, and one retrospective cohort study. Studies were small and together included a total of 379 subjects (mean of 42 subjects per study). N-acetylcysteine, heparin plus N-acetylcysteine, albuterol, ipratropium bromide, and saline were assessed. Studies reported no benefit of studied agents on expectoration, pulmonary function, and atelectasis and little effect on changes in sputum volume, weight, or viscosity. Adverse effects of agents were not consistently reported. Nausea was reported in 2 studies of N-acetylcysteine (one paper reported 2 experiments and did not clearly identify in which experiment adverse effects occurred), 3 studies reported that there were no adverse events, and 3 studies did not address adverse effects at all. Further research with clearly characterized populations and interventions is needed to understand the potential benefits and adverse effects of mucoactive agents.

BACKGROUND:The drug information curriculum in US colleges of pharmacy continues

Abstract

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Introduction Drug information, medical, and other resources, in the form of textbooks, online databases, and mobile applications (apps), are commonly consulted by health care professionals when providing answers to drug information questions or researching information prior to making recommendations for patient care. Thus, there is a need to train health care professionals on how to identify high‐quality resources to ensure patient safety and improve patient care. Given the variety of different resource types available in contemporary health care settings, a framework that can be universally applied to a variety of different resources is needed. Objective The primary objective of this paper is to introduce health care professionals to a unified framework for evaluating all types of tertiary health care resources that takes into account practical and contemporary considerations. The A2C2QUIRE framework centers around three main tenets: quality, functionality, and practical considerations, and specifically addresses the following components: Authorship and publisher, Accessibility, Currency of information, Cost and value of materials, Quality of content, Usability and resource design, Intent of the resource, Review process, and Endorsements. Conclusion The foundational concepts reviewed in this paper provide health care professionals with a unified framework for assessing the quality of various types of resources, while also incorporating practical and contemporary considerations.