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Acetadote (Acetylcysteine)
SIMPLE EXPLANATION
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.
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.
Uses: acetaminophen toxicity; cystic fibrosis; COPD, atelectasis.
Reference: Mosby's Nursing Drug Reference