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Acetadote (Acetylcysteine)

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SIMPLE EXPLANATION

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What is it and what does it do?

 

Acetadote (acetylcysteine) is basically the antidote for acetaminophen overdose. It works to prevent or at least lessen liver damage after a toxic quantity of acetaminophen has been ingested. It also works as a mucolytic, breaking down mucus secretions in certain lung conditions so the mucus may be coughed up or suctioned out.

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DETAILED EXPLANATION

 

Action: mucolytic action achieved by breaking disulfide links in mucoproteins, decreasing

              viscosity of secretions; acetaminophen antidote action achieved by acting as a substrate

              in place of glutathione, which is necessary to inactivate toxic metabolites.

 

Availability: prescription only.

 

Avoid: acetaminophen

 

Class (Chemical): amino acid L-cysteine.

 

Class (Functional): mucolytic; acetaminophen antidote.

 

Contraindications: hypersensitivity.

 

Dose: Acetaminophen Toxicity: Adult/Child PO: 140mg/kg, then 70mg/kg every four hours for

                                                                                     17 doses

                                                      41-100kg IV: loading dose 150mg/kg over 60 min, then 

                                                                             50mg/kg over 4hrs, then 100mg/kg over 16hrs

                                                      21-40kg IV: 150mg/kg in 100mL diluent over 1hr, then 50mg/kg

                                                                           in 250mL over 4hrs, then 100mg/kg in 500mL over

                                                                           16hrs

                                                      5-20kg IV: 150mg/kg in 3mL/kg diluent over 1hr, then 50mg/kg

                                                                          in 7mL/kg over 4hrs, then 100mg/kg in 14mL/kg

                                                                          over 16hrs

       Mucolytic: Adult/Child NEB: 1-10mL of 20% sol, or 2-20mL of 10% sol, every 2-8hrs

 

Notes: if used as mucolytic, assess cough frequently.

 

Off-Label Use: prevention of contrast medium nephrotoxicity.

 

Precautions: anemia; breastfeeding; chronic alcoholism; geriatric patients; pregnancy; renal

                      and/or hepatic disease.

 

Report to Provider: vomiting.

 

Routes: IV; NEB; PO.

 

Side Effects: dizziness; drowsiness; fever; chills; edema; flushing tachycardia; rhinorrhea;

                      pharyngitis; nausea; stomatitis; vomiting; anorexia; urticaria; rash; clamminess;

                      pruritis; bronchospasm; chest tightness; cough; dyspnea; anaphylaxis; angioedema;

                      unpleasant odor.

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Uses: acetaminophen toxicity; cystic fibrosis; COPD, atelectasis.

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Reference: Mosby's Nursing Drug Reference

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