Acetylcysteine (Mucomyst) description:Mayo Clinic:"Acetylcysteine (a-se-teel-SIS-teen) is a mucolytic (medicine that destroys or dissolves mucus). It is usually given by inhalation but may be given in other ways in a hospital. Acetylcysteine is used for certain lung conditions when increased amounts of mucus make breathing difficult. Acetylcysteine liquefies (thins) or dissolves mucus so that it may be coughed up. Sometimes the mucus may have to be removed by suction. This medicine is available only with your doctor's prescription, in the following dosage form: Inhalation Solution (U.S. and Canada)"
http://www.mayoclinic.com/findinformation/druginformation/druginvoke.cfm?objectId=00060D54-769C-1B79-AB8080AEBC2F0839

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Acetylcysteine (Mucomyst) indications for use:infomed:"Acetylcysteine is often used to dissolve mucus and to facilitate expectoration during respiratory diseases. While there are a number of open and controlled studies that suggest a considerable benefit, there are other controlled studies that do not demonstrate a significant effect. A formal meta-analysis does not exist; however, many specialists consider the beneficial effect of acetylcysteine marginal. There are doubts as to its clinically relevant effect, in particular concerning chronically obstructive lung disease and cystic fibrosis. However, other mucolytic agents are not particularly well documented either. Some specialists consider inhalation of acetylcysteine more effective than oral administration. The effect of acetylcysteine against paracetamol intoxication is well documented. If the treatment starts quickly (if possible within 8 to 10 hours after the administration of paracetamol), severe liver and kidney defects can be avoided."
http://www.infomed.org/100drugs/frames/acetfram.html

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Acetylcysteine (Mucomyst) action and kinetics:Nurses PDR:"Reduces the viscosity of purulent and nonpurulent pulmonary secretions and facilitates their removal by splitting disulfide bonds. Action increases with increasing pH (peak: pH 7-9). Onset, inhalation: Within 1 min; by direct instillation: immediate. Time to peak effect: 5-10 min. Also reduces liver injury due to acetaminophen overdosage by maintaining or restoring glutathione levels or by acting as an alternate substrate for the reactive metabolite of acetaminophen."
http://www.nursespdr.com/members/database/ndrhtml/acetylcysteine.html

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Acetylcysteine (Mucomyst) clinical pharmacology:rxlist:"The viscosity of pulmonary mucous secretions depends on the concentrations of mucoprotein and, to a lesser extent, deoxyribonucleic acid (DNA). The latter increases with increasing purulence owing to the presence of cellular debris. The mucolytic action of acetylcysteine is related to the sulfhydryl group in the molecule. This group probably “opens” disulfide linkages in mucus thereby lowering the viscosity. The mucolytic activity of acetylcysteine is unaltered by the presence of DNA, and increases with increasing pH. Significant mucolysis occurs between pH 7 and 9. Acetylcysteine undergoes rapid deacetylation in vivo to yield cysteine or oxidation to yield diacetylcystine. Occasionally, patients exposed to the inhalation of an acetylcysteine aerosol respond with the development of increased airways obstruction of varying and unpredictable severity. Those patients who are reactors cannot be identified a priori from a random patient population. Even when patients are known to have reacted previously to the inhalation of an acetylcysteine aerosol, they may not react during a subsequent treatment. The converse is also true; patients who have had inhalation treatments of acetylcysteine without incident may still react to a subsequent inhalation with increased airways obstruction. Most patients with bronchospasm are quickly relieved by the use of a bronchodilator given by nebulization. If bronchospasm progresses, the medication should be discontinued immediately."
http://www.rxlist.com/cgi/generic3/acetylcysteine_cp.htm


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Acetylcysteine (Mucomyst) side effects:accuratepharmacy.com:"Side effects that should be reported to your doctor: Less Common - Wheezing, Tightness in chest, Difficulty in breathing (especially asthma patients). Rare- Skin rash or other irritation. Other side effects that usually do not require medical attention: Less Common - Clammy skin, Fever, Increase in amount of mucus in lungs, Irritation or soreness of mouth, throat, or lungs, Nausea or vomiting, Runny nose, Store unopened vials at 59 to 86 F. Store opened vials in refrigerator. Discard opened vial after 96 hours"
http://www.accuratepharmacy.com/acetylcysteine.htm

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How to store and use Acetylcysteine (Mucomyst):medformation:"Solution:Your doctor will tell you how much medicine to use and how often to have your treatments. Carefully read and follow the instructions that come with the medicine. They will tell you how to use the nebulizer (the device that you use to breathe in the medicine) and compressor and how to care for and clean the nebulizer kit. The compressor turns the medicine into a fine spray that you will breath into your mouth using the nebulizer. Use the mouthpiece that comes with the nebulizer. Wash your hands with soap and water before putting the nebulizer together. Open the vial (small bottle of medicine) and pour the medicine into the nebulizer cup. Put the cap back on the cup. The medicine may have a bad smell at first. The odor should go away soon after you start your treatment, Turn on the compressor so mist is coming out of the nebulizer. Put the mouthpiece in your mouth, close your lips around it, and breathe in and out through your mouth. Make sure your teeth and tongue do not block the airflow. Keep breathing until the nebulizer cup is empty or no more mist is coming out. You may hear a sputtering sound when the cup is empty. When finished, turn off the compressor and clean the nebulizer and compressor. You may need to cough up and spit out mucus that collects in your throat."
http://www.medformation.com/mf/mm_qd.nsf/qd/dnx0857.htm

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Acetylcysteine (Mucomyst) dosage information::"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)"
http://www.medicalcorps.org/med-org/Meds/Acetylcysteine.htm

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Acetylcysteine (Mucomyst) range and frequency:wholehealthmd:"3 to 5 ml of 20% solution, or 6 to 10 ml of 10% solution by nebulizer every two to six hours. (The medicine may be inhaled through a face mask, mouthpiece, or via tracheostomy.) Or, 1 to 2 ml of 10% or 20% solution placed directly into the trachea via catheter every hour. The dosage differs from patient to patient; follow your doctor's directions carefully. Onset of Effect Within one minute. Duration of Action Up to several hours. Dietary Advice This drug should not be taken with meals. Be sure to drink plenty of fluids"
http://www.wholehealthmd.com/print/view/1%2C1560%2CDR_7%2C00.html

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