acetylcysteine

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