Acetylcysteine

Question 1

Generic name for Mucomyst

Answer 1

Acetylcysteine

Question 2

Trade name for Acetylcysteine

Answer 2

Mucomyst, Pravolex

Question 3

Classification of Acetylcysteine

Answer 3

Antidote for an acetaminophen overdose: mucolytic

Question 4

MOA(Pharmacodynamics) of Acetylcysteine

Answer 4

Decreases the buildup of a hepatotoxic metabolite in acetaminophen overdose. Action believed to restore hepatic glutathione or inactivate the toxic metabolite of acetaminophen to prevent hepatic damage. Exact mechanism unknown.

Question 5

Indications for Acetylcysteine

Answer 5

Acetaminophen antidote

Question 6

Dosage for Acetylcysteine

Answer 6

Acetaminophen toxicity: 150 mg/kg (maximum 15 g) IV over 60 minutes (mix in N/S); followed by
First maintenance dose: 50 mg/kg (maximum 5 g) IV over 4 hours; then
Second maintenance dose: 100mg/kg (maximum 10 g) over 16 hours

Pediatric: 50 mg/kg over 60 mins

Question 7

Contraindications for Acetylcysteine

Answer 7

Hypersensitivity to the drug; administering the loading dose over 60 minutes may decrease the incidence of hypersensitivity reactions

Question 8

Precautions with Acetylcysteine

Answer 8

• Use cautiously in patients with asthma or a history of bronchospasm (may exacerbate)
• Elderly or debilitated patients with severe respiratory insufficiency

Question 9

Notable notes regarding Acetylcysteine

Answer 9

• Ideally this should be given less than 8 hours after ingestion
• Must be refrigerated
• Has an unpleasant odor
• Will discolor after opening (this does not impair its effectiveness)
• There are also PO dosages. These will be absorbed if activated charcoal is administered also.