n-Acetylcysteine (mucomyst, Acetadote)

Question 1

Class

Answer 1

Antidote, mucolytic

Question 2

Mechanism of action

Answer 2

Primary and most effective treatment for acetaminophen overdose. Also administered as a mucolytic to patients with thick pulmonary secretions from a variety of lung conditions.

Question 3

Onset and duration

Answer 3

Peak:
PO: 1-2 hours
Duration: 5.6 hour half life

Question 4

Indications

Answer 4

Acetaminophen overdose

Question 5

Contraindications

Answer 5

Hypersensitivity, acute asthma

Question 6

Adverse reactions

Answer 6

Nausea/ vomiting 
Edema
Flushing 
Tachycardia 
Hypotension

Question 7

Drug interactions

Answer 7

None

Question 8

How supplied

Answer 8

10% and 20% oral solutions, 20% IV solution (30 ML)

Question 9

Dosage and administration - adult and pediatric

Answer 9

Oral: 140 mg/kg loading dose, followed by 70 mg/kg q 4 hours for 17 additional doses
IV: 300 mg/kg in 3 doses over 21 hours: loading dose of 150 mg/ kg in 200 ml of 5% dextrose over 1 hour, second dose 50mg/kg in 500 ml over 4 hours, 3rd dose 100 mg/kg in 1000 ml over 16 hours
Contact poison control for dosing in pediatrics < 20kg

Question 10

Special considerations

Answer 10

Pregnancy safety category B
Consult medical control prior to administration
Consider activated charcoal instead if within 1 hour of ingestion
Nausea and vomiting frequently occur with Oral administration, consider antiemetic