Pharmacologic class

Mucolytic, antidote
Brand Names
Mucomyst, Acetadote
Indications
Adjuvant therapy for abnormal, viscid, or inspissated mucous secretions (e.g. acute or chronic bronchopulmonary disease, cystic fibrosis, chest trauma, anesthesia, tracheostomy, atelectasis related to mucous obstruction, bronchoscopy)
Acetaminophen overdose
Amanita phalloides poisoning
Pharmacology
Decreases viscosity of mucous secretions by uncoupling disulfide linkages. Mucolytic effect increases with increasing pH (maximim effectiveness occurs between pH 7-9).
Protects hepatic tissue possibly by restoring glutathione level, or acting as a substitute reagent for the detoxification of the reactive metabolite. Exact mechanism unknown.
Contraindications
Allergy to acetylcysteine
Precautions
Use cautiously when given orally in patients at risk for gastric bleeding due to the increased potential for vomiting.
Interactions
Nitrates: increased headaches
Carbamazepine: decreased carbamazepine level
Adverse Reactions
Stomatitis, nausea, vomiting, fever, rhinorrhea, drowsiness, clamminess, chest tightness, bronchoconstriction, bronchospasm, rash
Additional Information
Acetylcysteine can be given orally, IV, by inhalation, or by instillation into an endotracheal or tracheostomy tube.
Date of most recent Update
September 28, 2005
Further information is available in the writeup for the brand name(s) of this medication

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