Content
The content of medical knowledge in this section of the site of the Lactology Foundation is intended for the practical needs of doctors, pharmacists and students in these specialties. It is more than reasonable to consult other authoritative medical sources before using our medical knowledge.
- Lung in Health and Disease
- General Approach to Patients
With Respiratory Disorders - Evaluating Lung Structure and Function
- Interstitial Lung Diseases
- Pulmonary Vascular Diseases
- Disorders of the Pleura,
Mediastinum, and Chest Wall - Respiratory Failure
- Lung Transplantation
- Perioperative Pulmonary Management
- COVID-19 Pulmonary Management
- Congenital Lung Malformations
- Sleep-Related Disorders
Expectoration
Expectoration of sputum, i. e.,
tracheo-
bronchial secretion
mixed with saliva, is an important
symptoms of diseases of the
respiratory tract.
Pathophysiology
Expectoration of sputum,
i. e., tracheo-
bronchial secretion mixed
with saliva, is an important
symptoms of
diseases of the respiratory tract. Under nor-
mal circumstances an approximately 5 μm thick
mucus
layer covers the airways and protects
the bronchi
epithelium against inhaled
noxious substances. This
continuously renewed
mucus is transported by the res-
piratory
cilia towards the oropharynx. It will be swal-
lowered under normal circumstances and coughed
up, if
its quantity is increased. The normal
amount of secret-
tion is about 100 mL per
day.
Sputum production is increased by any
injury of the
bronchial tree or the lung
parenchyma due to inhalation
noxious
substances or by inflammation. Enhanced
sputum production is a hallmark for airway
injury or in-
flammation. Most inflammatory
diseases of the bronchi
(e. g., bronchitis,
asthma, and bronchiectasis) and of the
lung
parenchyma (pneumonia) are associated with
sputum production.
Appearance and Composition
According to
the color of the sputum a distinction is made
between mucous (whitish), mucopurulent, and
purulent (yellowish) expectoration. The yellow
or green color of the sputum is
due to
leucoproteins and leucoverdins, which mainly
originate from decaying inflammatory cells, i.
e., neutrophils and eosinophils and only
partially from bacterial products. If sputum
contains blood its color turns from faint red to
dark brown according to the amount of blood and
the time course of bleeding.
Sputum consists
of 95% water and only 5% organic
components,
e. g., substances such as high molecular
weight mucins, secretory IgA, etc. It contains
substances
that transude or exude from the
blood, such as fibrino-
gene or albumin. In
addition, it contains cells from the
blood or
exfoliated epithelial cells. Cell products and
mediators are further components of the complex
com-
position of the secretion.
Sputum is
a product of secretion, transudation, ex-
udation, and exfoliation of a highly complex
mucous
membrane. Its composition reflects
inflammation
and neoplastic processes of the
respiratory tract.
Cytologic and
bacteriologic examination of the sputum
(Giemsa and Gram preparations) allows
characteriza-
tion of airway inflammation,
detection of neoplasms
and identification of
microorganisms responsible for
bacterial and
fungal infections.
Please see also our Toxilact data base which is in the following language versions:
Toxilact Deutsche Sprachversion
Toxilact Nederlandstalige versie
Toxilakt έκδοση στην ελληνική γλώσσα
Toxilact English language version
Toxilact magyar nyelvű változat
Toxilact versione in lingua italiana
Toxilact polska wersja językowa
Pulmonary symptoms, findings and investigations
Assessment of chronic cough
Expectoration
Hemoptysis
Pleural Effusion
Approach to wheezing in children
Polysomnography
Pulmonary Function Testing
Toxicological risk during lactation
Toxicological lactation category I - the drug and/or its metabolites are either not eliminated through breast milk or are not toxic to the newborn and cannot lead to the development of absolutely any toxic reactions and adverse consequences for his health in the near and long term. Breast-feeding does not need to be discontinued while taking a given drug that falls into this toxicological lactation category.
Toxicological lactation category II - the drug and its metabolites are also eliminated through breast milk, but the plasma:milk ratio is very low and/or the excreted amounts cannot generate toxic reactions in the newborn due to various reasons, including degradation of the drug in the acid pool of the stomach of the newborn. Breastfeeding does not need to be discontinued while taking this medicine.
Toxicological lactation category III - the drug and/or its metabolites generate in breast milk equal to plasma concentrations or higher, and therefore the possible development of toxic reactions in the newborn can be expected. Breastfeeding should be discontinued for the period corresponding to the complete elimination of the drug or its metabolites from the mother's plasma.
Toxicological lactation category IV - the drug and/or its metabolites generate a plasma:milk ratio of 1:1 or higher and/or have a highly toxic profile for both the mother and the newborn, therefore their administration is incompatible with breastfeeding and it should to stop completely, and not just for the period of taking the drug, or to look for a less toxic therapeutic alternative.