Acetylcysteine (a solution of 20 % for inhalations)
Solutio Acetylcysteini 20 % pro ingalationis
International nonproprietary name
Acetylcysteinum.
Acetylcysteine.
Pharmacotherapeutic group
Mucolytics
Composition of the preparation
1 ml of the solution for inhalations contains 200 mg of Acetylcysteine.
Pharmacological action
Pharmacodynamics
Mucolytic agent. Liquefies sputum, enlarges its volume, facilitates excretion, and promotes an expectoration. Action of the preparation is related to the ability of its sulfhydryl groups to break disulfide bonds of sputum acidic mucopolysaccharides that leads to depolarization of mucoproteins and to decrease of mucus viscosity. The preparation keeps activity at purulent sputum.
Has antioxidant effect caused by presence of SH-group, capable to react and to neutralize electrophylic oxidizing toxins. Acetylcysteine promotes increase of glutathione synthesis which is the important antioxidant factor of intracellular protection and provides maintenance of functional activity and morphological integrity of a cell.
Pharmakokinetics
Binding with plasma proteins is 50 % at penetration into systemic blood flow. Passes through a placental barrier, found out in an amniotic fluid. It is determined in plasma in not changed form, and also in a form of metabolites of N-acetylcysteine, NN-diacetylcysteine and cysteine ether. The renal clearance is 30 % of the total clearance. The insignificant part is eliminated in not changed form through an intestine.
Indications
Diseases of organs of respiration and the conditions, accompanied by formation of a viscous and mucopurulent sputum: acute and chronic bronchitis, tracheitis due to bacterial and/or virus infection, pneumonia, bronchoectatic disease, bronchial asthma, atelectasis due to bronchuses occlusion by mucous impaction, mucoviscidosis (in a structure of the combined therapy). Elimination of viscous secret from respiratory ways at posttraumatic and postoperative conditions, facilitating of secretion at sinusitis.
Dosage and method of administration
Apply Acetylcysteinem in the form of inhalations per 2-5 ml of 20 % solution 3-4 times a day (duration of inhalation is 15-20 mines).
Special indications
The preparation should be administrated with care to patients with bronchial asthma.
It is necessary to use glass vessels, avoiding contact with metals and rubber (formation of sulfides with characteristic smell is possible) at work with the preparation.
Side effects
The preparation is usually well tolerated. The nausea is possible in some cases (connected mainly with specific smell of the preparation), reflex cough, local irritation of respiratory tract, rarely - stomatitis, rhinitis.
Contraindications
Stomach and duodenum ulcer in a phase of exacerbation, pneumorrhagia, pulmonary bleeding, bronchial asthma (without sputum condensation). The high individual sensitivity to Acetylcysteine.
At pregnancy and lactation is applied only in case if the prospective benefit for mother exceeds potential risk for a fetus or a baby.
Safety measures
It is necessary to apply with care in persons disposed to bronchospasm (bronchodilatory agents should be administrated at bronchospasm). Acetylcysteine should be administrated with care at disposition to pulmonary bleedings, diseases of liver, kidneys, and dysfunctions of adrenals.
It is necessary to control functions of liver, kidneys and adrenals, to check enzymatic parameters of blood at long-term indication.
Interactions with other medicinal preparations
Acetylcysteine increases (mutually) bronchial spasmolytics effect.
Mixing of Acetylcysteine solutions of with solutions of antibiotics and proteolytic enzymes can cause an inactivation of the preparation. Simultaneous application of Acetylcysteine with antitussive drugs can strengthen sputum congestion because of suppression of cough reflex.
Acetylcysteine reduces hepatotoxic action of Paracetamol.
The form of release
20 % solution for inhalations in 5 ml ampoules. 5 or 10 ampoules in a box.
