Acetylcysteine (Mucomyst, Mucosil)

Category:

  • Miscellaneous

Description:

  • Mucolytic, acetaminophen antidote

Indications:

  • Antidote for acetaminophen overdose

  • Mucolytic

  • Adjunct therapy for abnormal, viscid, or inspissated mucus secretions in chronic broncho-pulmonary disease

Contraindications:

  • Increased intracranial pressure

  • Status asthmaticus

Precautions:

  • Pregnancy category B

  • Hypothyroidism; Addison’s disease, CNS depression, brain tumor, asthma, COPD

  • Hepatic disease, alcoholism, seizure disorders, renal disease, psychosis

  • AVOID use with iron, copper, rubber

  • Disagreeable odor may be noted

  • Discoloration of solution is of no significance

Adverse Reactions (Side Effects):

  • CNS: chills, dizziness, drowsiness, fever, headache

  • EENT: rhinorrhea

  • GI: anorexia, nausea, stomatitis, vomiting

  • RESP: bronchospasm, chest tightness

  • SKIN: clamminess, fever, rash, urticaria

Dosage:

Administered via nebulization (inhalation) or orally

Adult and Child:

  • Mucolytic: 

    • Instill 1-2 ml (10%-20% solution) every 1-4 hours as needed

    • nebulize 3-5 ml (20% solution) or 6-10 ml (10% solution) three times daily

  • Acetaminophen toxicity: 

    • PO 140 mg/kg, then 70 mg/kg every 4 hours for 17 doses to total 1330 mg/kg; (dilute 20% solution to concentration of 5%; dilutions should be freshly prepared and utilized within 1 hour)

 
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