Acetylcysteinum

General characteristics. Structure:

Active ingredient: 200 mg of Acetylcysteinum in 1 capsule.

The drug having mucolytic, expectorant, detoksitsiruyushchy effect.

Pharmacological properties:

Pharmacodynamics. Due to existence of free sulphhydryl group terminates disulfide bridges of acid mucopolysaccharides of a phlegm, slows down polymerization of mukoproteid and reduces viscosity of slime.

Liquefies a phlegm and considerably increases its volume (in some cases use of a suction is required to prevent "flooding" of lungs). Has a promoting effect on mucous cells which secret lyses fibrin. Increases synthesis of glutathione and activates processes of a detoxication. Has the antiinflammatory properties caused by suppression of formation of the free radicals and reactive oxygen metabolites responsible for development of an acute and chronic inflammation in pulmonary fabric and pneumatic ways.

Pharmacokinetics. At intake it is well soaked up, however bioavailability low — no more than 10% (at "the first passing" through a liver it dezatsetilirutsya with formation of cysteine), Cmax is reached in 1–3 h. Linkng with proteins of plasma makes about 50%. Gets through a placental barrier, it is found in amniotic liquid. There is 1 h T1/2 at intake, at cirrhosis increases to 8 h. It is removed generally by kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteinum), an insignificant part is allocated in not changed look with intestines.

Indications to use:

The complicated department of a phlegm (bronchitis, tracheitis, bronchiolitis, pneumonia, bronchoectatic disease), mucoviscidosis, lung abscess, emphysema of lungs, laryngotracheitis, intersticial diseases of lungs, bronchial asthma, lung atelectasis (owing to obstruction of bronchial tubes a mucous stopper), catarral and purulent otitis, sinusitis, including antritis, removal of a viscous secret from respiratory tracts at posttraumatic and postoperative states, poisoning with paracetamol (as an antidote).

Route of administration and doses:

Inside, in/in, in oil, it is inhalation, endobronkhialno, locally. Dosing mode individual. Inside, adult — 400–600 mg/days in 2–3 receptions. The single dose for children depends on age.

In/in or in oil, adult — on 300 mg of 1 times a day, children are from 6 to 14 years old — on 150 mg of 1 times a day, to children under 6 years performing peroral therapy is preferable, however in the presence of indications and need of parenteral administration the daily dose makes 10 mg/kg of body weight. To children aged till 1 year in/in introduction it is possible only according to vital indications in the conditions of a hospital.

It is inhalation, on 2–5 ml of 20% of solution 3–4 times a day (within 15–20 min.).

Locally, for washing of acoustical passes, the nasal courses (on 1 procedure — 1,5–3 ml of 10% of solution).

Features of use:

At patients with a bronkhoobstruktivny syndrome (develops rather often against the background of strengthening of a bronchospasm) Acetylcysteinum needs to be combined with bronchial spasmolytics.

Use at pregnancy and feeding by a breast. At pregnancy it is possible if the expected effect of therapy exceeds potential risk for a fruit.

Category of action on a fruit on FDA — B.

Side effects:

From bodies of a GIT: nausea, vomiting, heartburn, feeling of overflow of a stomach, stomatitis.

Allergic reactions: skin rash, an itch, a small tortoiseshell, a bronchospasm (it is preferential at patients with hyperreactivity of bronchial tubes).

Others: drowsiness, fever; seldom — a sonitus; reflex cough, local irritation of respiratory tracts, a rhinorrhea (at inhalation use); burning in the place of an injection (at parenteral use).

Interaction with other medicines:

Simultaneous use of Acetylcysteinum and antibechics can increase stagnation of a phlegm because of suppression of a tussive reflex (it is not necessary to apply at the same time).

At combined use with antibiotics, such as tetracyclines (excepting doxycycline), ampicillin, Amphotericinum In, their interaction with thiol SH group of Acetylcysteinum is possible that leads to decrease of the activity of both drugs (the interval between reception of Acetylcysteinum and antibiotics has to make not less than 2 h).

At a concomitant use of Acetylcysteinum and nitroglycerine strengthening of vasodilating and antiagregantny action of the last is possible.

Acetylcysteinum reduces a hepatotoxic action of paracetamol.

Pharmaceutical it is incompatible with solutions of other HP.

At contact with metals, rubber forms sulfides with a characteristic smell.

Contraindications:

Hypersensitivity, peptic ulcer of a stomach and duodenum in an aggravation stage.

Restrictions to use. A peptic ulcer of a stomach and duodenum, a gullet varicosity, a pneumorrhagia, pulmonary bleeding, a fenilketonuriya, bronchial asthma without condensation of a phlegm, a disease of adrenal glands, arterial hypertension, a liver and/or renal failure.

Storage conditions:

To store at a temperature of 15-25 °C, in dry, protected from light and the place, unavailable to children. Period of validity 3 years. Not to use after the expiry date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Capsules on 200 mg. On 10 capsules in each blister, on one, two or three blisters together with the application instruction in cardboard packaging.