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)