N-Acetyl Cysteine (Acetadote)
Mechanism of action
Mucolytic activity is partly done by hydrolization of disulfide bonds within mucin by NAC’s sulfhydryl groups, which makes the mucin less viscous. Second mechanism is decrease of transcription of the gene responsible for production of mucin due to NAC’s antioxidant effect.
In overdose, paracetamol is metabolized into potentially hepatotoxic metabolite NAPQI (N-acetyl-p-benzoquinone imine) which depletes glutathione stores in the liver and accumulates. N-Acetyl-Cysteine (NAC) as a sulfhydryl donor increases the glutathione availability, thus the ability to break down NAPQI. Also, direct binding to NAPQI and reverse reduction of NAPQI back to paracetamol are other mechanisms of action.
Indications and dose
Pharmacokinetics
Onset of action:
- IV: Rapid
- PO: 5–10 minutes
Duration of action: 8 hours (peroral)
Half-life of elimination: 5.6 hours
Metabolism: Hepatic (deacetylated to cysteine)
Elimination: Kidneys (20–30 % as an unchanged drug)
Directions for administration
A maximum weight of 110 kg should be used when calculation the dosage for obese patients.
Tablets should be taken after food.
Medicinal forms
Solution for Injection/Infusion
- 1 vial = 3 ml with 300 mg (100 mg/ml)
Pills – 600 mg
Side-effects
Nausea, vomiting
Flushing, skin rash
Anaphylactoid reaction
References
