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ACETYLCYSTEINE

Stephen Josh V. Lim BSN 3A


Generic Name ACETYLCYSTEINE

Brand Name Airbron, Mucomyst,


Mucosol, N-
Acetylcysteine,
Acetadote, Acys-5

Classification SKIN AND MUCOUS MEMBRANE AGENT; MUCOLYTIC;


ANTIDOTE
General Action Acetylcysteine probably acts by disrupting disulfide linkages of
mucoproteins in purulent and nonpurulent secretions.
Dose and Route Mucolytic
Adult: Inhalation 1–10 mL of 20% solution q4–6h or 2–20 mL of 10%
solution q4–6h Direct Instillation 1–2 mL of 10–20% solution q1–4h
Child: Inhalation 3–5 mL of 20% solution or 6–10 mL of 10% solution 3–
4 times/d
Infant: Inhalation 1–2 mL 20% solution or 2–4 mL of 10% solution 3–4
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: IV 150 mg/kg infused over 15 min, followed by 50
mg/kg over 4 h, then 100 mg/kg over 16 h; OR 140 mg/kg infused over 1 h,
then, 4 h after the loading dose, give 70 mg/kg q4h x 12 doses

Indications or Adjuvant therapy in patients with abnormal, viscid, or inspissated mucous


Purposes 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.
Side effects CNS: Dizziness, drowsiness.

GI: Nausea, vomiting, stomatitis, hepatotoxicity (urticaria).

Respiratory: Bronchospasm, rhinorrhea, burning sensation in upper


respiratory passages, epistaxis.
Contraindications
Hypersensitivity to acetylcysteine; patients at risk of gastric hemorrhage.

Nursing
Responsibilities Assessment & Drug Effects

 During IV infusion, carefully monitor for fluid overload and signs


of hyponatremia (i.e., changes in mental status).

 Monitor for S&S of aspiration of excess secretions, and for


bronchospasm (unpredictable); withhold drug and notify physician
immediately if either occurs.

 Lab tests: Monitor ABGs, pulmonary functions and pulse oximetry


as indicated.

 Have suction apparatus immediately available. Increased volume of


respiratory tract fluid may be liberated; suction or endotracheal
aspiration may be necessary to establish and maintain an open
airway. Older adults and debilitated patients are particularly at risk.

 Nausea and vomiting may occur, particularly when face mask is


used, due to unpleasant odor of drug and excess volume of liquefied
bronchial secretions.

Patient & Family Education

 Report difficulty with clearing the airway or any other respiratory


distress.

 Report nausea, as an antiemetic may be indicated.

 Note: Unpleasant odor of inhaled drug becomes less noticeable with


continued use.

 Do not breast feed while taking this drug without consulting


physician.