![]() ![]() Long-term oral studies of acetylcysteine alone in rats (12 months of treatment followed by 6 months of observation) at doses up to 1,000 mg/kg/day (5.2 times the human mucolytic dose) provided no evidence of oncogenic activity. Carcinogenesis, Mutagenesis, Impairment of FertilityĬarcinogenicity studies in laboratory animals have not been performed with acetylcysteine alone, nor with acetylcysteine in combination with isoproterenol. Drug Interactionsĭrug stability and safety of acetylcysteine when mixed with other drugs in a nebulizer have not been established. Dilution of the nebulizing solution with appropriate amounts of Sterile Water for Injection, USP, as concentration occurs, will obviate this problem. Extreme concentration may impede nebulization and efficient delivery of the drug. Continued nebulization of Acetylcysteine Solution with a dry gas will result in an increased concentration of the drug in the nebulizer because of evaporation of the solvent. ![]() The light purple color is the result of a chemical reaction which does not significantly affect the safety or mucolytic effectiveness of acetylcysteine. Under certain conditions, a color change may occur in acetylcysteine in the opened bottle. This is easily removed by washing with water. With a face mask there may be stickiness on the face after nebulization. With the administration of acetylcysteine, the patient may observe initially a slight disagreeable odor that is soon not noticeable. If bronchospasm progresses, the medication should be discontinued immediately. Most patients with bronchospasm are quickly relieved by the use of a bronchodilator given by nebulization. Asthmatics under treatment with acetylcysteine should be watched carefully. When there is a mechanical block due to foreign body or local accumulation, the airway should be cleared by endotracheal aspiration, with or without bronchoscopy. When cough is inadequate, the airway must be maintained open by mechanical suction if necessary. ![]() WARNINGS:Īfter proper administration of acetylcysteine, an increased volume of liquified bronchial secretions may occur. Pulmonary complications associated with surgeryĭiagnostic bronchial studies (bronchograms, bronchospirometry, and bronchial wedge catheterization) CONTRAINDICATIONS:Īcetylcysteine is contraindicated in those patients who are sensitive to it. Pulmonary complications of cystic fibrosis INDICATIONS AND USAGE:Īcetylcysteine Solution, USP is indicated as adjuvant therapy for patients with abnormal, viscid, or inspissated mucous secretions in such conditions as:Ĭhronic bronchopulmonary disease (chronic emphysema, emphysema with bronchitis, chronic asthmatic bronchitis, tuberculosis, bronchiectasis and primary amyloidosis of the lung)Īcute bronchopulmonary disease (pneumonia, bronchitis, tracheobronchitis) The converse is also true patients who have had inhalation treatments of acetylcysteine without incident may still react to subsequent inhalation with increased airways obstruction. Even when patients are known to have reacted previously to the inhalation of an acetylcysteine aerosol, they may not react during a subsequent treatment. Those patients who are reactors cannot be identified a priori from a random patient population. Occasionally, patients exposed to the inhalation of an acetylcysteine aerosol respond with the development of increased airways obstruction of varying and unpredictable severity. Significant mucolysis occurs between pH 7 and 9.Īcetylcysteine undergoes rapid deacetylation in vivo to yield cysteine or oxidation to yield diacetylcystine. The mucolytic activity of acetylcysteine is unaltered by the presence of DNA, and increases with increasing pH. This group probably “opens” disulfide linkages in mucus thereby lowering the viscosity. The mucolytic action of acetylcysteine is related to the sulfhydryl group in the molecule. The latter increases with increasing purulence owing to the presence of cellular debris. The viscosity of pulmonary mucous secretions depends on the concentrations of mucoprotein and, to a lesser extent, deoxyribonucleic acid (DNA). Related/similar drugs acetylcysteine, ambroxol, ascorbic acid, biotin, Vitamin C, niacin, multivitamin ACETYLCYSTEINE AS A MUCOLYTIC AGENT ![]()
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