Acetylcysteine
AcetylcysteineClassAntidoteMucolyticTrade NamesAcetadote-
Injection, solution 20% (200 mg/mL)
Acetylcysteine- Solution, inhalation or oral 10%- Solution,
concentrate, inhalation or oral 20%Indications chronic
bronchopulmonary disease (chronic emphysema, emphysema with
bronchitis, chronic asthmatic bronchitis, tuberculosis,
bronchiectasis acute bronchopulmonary disease (pneumonia,
bronchitis, tracheobronchitis), pulmonary complications of cystic
fibrosis, tracheostomy care, pulmonary complications associated
with surgery, during anesthesia, posttraumatic chest conditions,
atelectasis caused by mucous obstruction, diagnostic bronchial
studies (eg, bronchograms, bronchospirometry, bronchial wedge
catheterization) (inhalation); prevention or lessening of liver
damage after potentially toxic quantity of acetaminophen (oral or
IV).Unlabeled UsesOphthalmic preparation for dry eyesenema for
bowel obstructionprevention of radiocontrast-induced
nephrotoxicityH pylori infection
N-acetyl-p-benzoquinone imine acetylcysteine acts to maintain or
replenish depleted glutathione reserves in the liver and enhance
non-toxic metabolism of acetaminophenContraindicationsSensitivity
to acetylcysteineUse with caution in patients with asthma or a
history of bronchospasmAdministrationInhalation Direct instillation
into a particular segment of the bronchopulmonary tree Direct
instillation into percutaneous intratracheal catheterDirect
instillation for routine care of tracheostomyNebulization with face
mask, mouth piece, tracheostomyIVOral
Acetaminophen OverdoseLoading dose 150 mg/kg in 200 mL of
diluent infused over 60 min.Maintenance dose 50 mg/kg in 500 mL of
diluent infused over 4 h followed by 100 mg/kg in 1,000 mL of
diluent infused over 16 h.
PO 140 mg/kg loading dose administered immediately if 24 h or
less have elapsed from the reported time of ingestion of an
acetaminophen overdose, then 70 mg/kg 4 h after loading dose and
repeated at 4-h intervals for total of 17 doses, unless
acetaminophen assay indicates otherwise.On admission, draw a serum
blood sample at least 4 h after ingestion to determine the
acetaminophen level, which will serve as a basis for determining
the need for treatment.Administer acetylcysteine within 8 h from
acetaminophen ingestion for max protection against hepatic
injury.Acetylcysteine is compatible with dextrose 5%, sodium
chloride 0.45% injection, and water for injection
Administer diluted solution within 1 h of preparation.If the
patient vomits within 1 h of administration, repeat that
dose.StorageInhalation or oral solution Use freshly prepared
solutions within 1 h.Discard any unused solution after 96
hInjectionDiluted solution is stable for up to 24 h Adverse
ReactionsTachycardia, hypotensionRash, flushing, pruritus,
urticariaPharyngitis, rhinorrhea, throat tightness Vomiting,
nausea, stomatitisRhonchi, bronchoconstriction; bronchospasm;
irritation to the tracheal and bronchial tracts; hemoptysis; edema,
MiscellaneousAnaphylaxis, chest tightness; clamminess; drowsiness;
fever;
