ACETYLCYSTEINE ![]() (a-se-til-sis'tay-een) ![]() Airbron ![]() Classifications: mucolytic agent; antidote; Therapeutic:mucolytic; antidote Pregnancy Category: B |
10%, 20% solution for inhalation; 20% solution for injection
Acetylcysteine probably acts by disrupting disulfide linkages of mucoproteins in purulent and nonpurulent bronchial secretions. In acetaminophen overdose, it helps to prevent hepatotoxicity by serving as a substrate for the toxic metabolites of acetaminophen.
Lowers viscosity and facilitates the removal of secretions.
Adjuvant therapy in patients with abnormal, viscid, or inspissated mucous secretions in acute and chronic bronchopulmonary diseases, and in pulmonary complications of cystic fibrosis and surgery, tracheostomy, and atelectasis. Also used in diagnostic bronchial studies and as an antidote for acute acetaminophen poisoning.
As an ophthalmic solution for treatment of dry eye (keratoconjunctivitis sicca); as an enema to treat bowel obstruction due to meconium ileus; prevention of radiocontrast-induced renal dysfunction.
Hypersensitivity to acetylcysteine; patients at risk of gastric hemorrhage.
Patients with asthma, older adults, severe hepatic disease, esophageal varices, peptic ulcer disease; debilitated patients with severe respiratory insufficiency, pregnancy (category B), lactation.
Mucolytic Adult: Inhalation 110 mL of 20% solution q46h or 220 mL of 10% solution q46h Direct Instillation 12 mL of 1020% solution q14h Child: Inhalation 35 mL of 20% solution or 610 mL of 10% solution 34 times/d Infant: Inhalation 12 mL 20% solution or 24 mL of 10% solution 34 times/d Acetaminophen Toxicity Adult/Child: PO 140 mg/kg followed by 70 mg/kg q4h for 17 doses (use a 5% solution) Adult/Adolescent/Child: IV 150 mg/kg infused over 60 min, followed by 50 mg/kg over 4 h, then 100 mg/kg over 16 h; total dose 300 mg/kg over 21 h |
Intravenous PREPARE: IV Infusion: Acetylcysteine reacts with certain metals and rubber; use IV equipment made of plastic or glass. Dilute all required doses in D5W as follows: for loading dose, add a dose equal to 150 mg/kg to 200 mL; for first maintenance dose, add a dose equal to 50 mg/kg to 500 mL; for second maintenance dose, add a dose equal to 100 mg/kg to 1000 mL. Note: The total IV volume should be reduced for patients <40 kg and for those with fluid restriction. In small children, individualize the total IV volume to avoid water intoxication and hyponatremia. ADMINISTER: IV Infusion: Give loading dose over 60 min, maintenance dose 1 over 4 h, maintenance dose 2 over 16 h. INCOMPATIBILITIES Y-site: Cefepime, ceftazidime.
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