Drug of the week- RT 101
Each week a drug will be introduced, during the pharmacology section all drugs and classifications will be discussed
Week 4- Mucomyst
This medication, when inhaled by mouth, works in the lung to thin mucous, making breathing easier. It is used to treat thick mucous secretions in chronic emphysema, bronchitis, pneumonia, cystic fibrosis and other related conditions. This medication is also swallowed by mouth as an antidote to acetaminophen (Aspirin) overdose in order to prevent life-threatening liver damage. Acetylcysteine has also been swallowed by mouth to prevent kidney failure due to X-ray contrast products. When used to thin mucus, this medication is inhaled into the lungs using special breathing (nebulizer) equipment. For acetaminophen overdose, this medication is generally used every 4 hours. When using this to thin mucus, it may cause nausea, vomiting, drowsiness, runny nose, clamminess, fever and an unpleasant odor the first several days as your body adjusts to the medication. Many people using this medication do not have serious side effects. Some side effects are: rash, mouth sores, breathing trouble. If using a face mask, your face may feel sticky after use. Wipe clean with water. When using this medication by mouth for acetaminophen overdose or to prevent kidney problems, it may cause or aggravate nausea and vomiting. Diluted solutions of this medication may minimize this problem.
Generic Name: Airbron, Mucomyst, Parvolex
Trade Name: ACETYLCYSTEINE
Classification: Mucomyst contains the medicine N-acetylcysteine which is a mucolytic
Purpose: Mucomyst is used to thin secretions in patients with; Pneumonia, Cystic Fibrosis, Bronchitis, Emphysema, respiratory tract infections and similar conditions that produce increased amounts of secretions. Also used for acetaminophen overdose, but RT’s do not administer it for this purpose.
How it works: Acetylcysteine is related to the sulfhydryl group in the molecule. It disrupts the structure of the mucus molecule by substituting its own sulfhydril groups for the disulfide bonds in the mucus.
Delivery Device: As an aerosol or tablet. RT’s give it via HHN/SVN in aerosol form. Also used during a bronchoscopy instilled directly into the lung by the physician.
Doses: Given in two strengths 10% 2-3 cc TID or QID solution and 20% solution 1-3 cc TID or QID. This drug is always mixed with an adrenergic bronchodilator in a nebulizer.
Precautions: Do not give without a bronchodilator, may cause bronchospasm especially in Asthmatics. Mucomyst is incompatible in mixture with the following antibiotics and should not be combined in physical solution: Sodium ampicillin, Amphotericin B, Erthromycin, Tertracyclines.
Store unopened solution at room temperature between 59 and 86 degrees F (15 and 30 degrees C) away from heat and light. Once opened, store the solution in the refrigerator and use within 96 hours. The solution may change color, but will continue to be safe and effective if used within 96 hours after opening. Diluted solutions to be swallowed by mouth should be used within 1 hour of preparation.
Mucomyst creates an unpleasant “rotten egg” order or sulfur smell that may make some patients fell nausea. Explain to the patient to expect an unpleasant odor before administering.
Though mucomyst can be given to Cystic Fibrosis patients, the use of DORNASE ALFA (PULMOZYME) is usually given instead. Dornase Alfa is a mucolytic specifically engineered to react with DNase enzyme for patients with Cystic Fibrosis.