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User:Mr. Ibrahem/Acetylcysteine

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Mr. Ibrahem/Acetylcysteine
Clinical data
Pronunciation/əˌsiːtəlˈsɪstiiːn/ and similar (/əˌsɛtəl-, ˌæsɪtəl-, -tiːn/)
Trade namesAcetadote, Fluimucil, Mucomyst, others
Other namesN-acetylcysteine; N-acetyl-L-cysteine; NALC; NAC
AHFS/Drugs.comMonograph
License data
Pregnancy
category
  • AU: B2
Routes of
administration		By mouth, injection, inhalation
Legal status
Legal status
  • AU: S2 (Pharmacy medicine)
  • BR: OTC (Over the counter) (by mouth, IV, inhalation)
  • US: OTC (by mouth), Rx-only (IV, inhalation)
Pharmacokinetic data
Bioavailability10% (by mouth)[1]
Protein binding50 to 83%[2]
MetabolismLiver[2]
Elimination half-life5.6 hours[3]
ExcretionKidney (30%),[2] faecal (3%)
Identifiers
  • (2R)-2-acetamido-3-sulfanylpropanoic acid[4]
Chemical and physical data
FormulaC5H9NO3S
Molar mass163.195 g·mol−1
3D model (JSmol)
Specific rotation+5° (c = 3% in water)[5]
Melting point109 to 110 °C (228 to 230 °F) [5]
  • C/C(=N/[C@@H](CS)C(=O)O)/O
  • InChI=1S/C5H9NO3S/c1-3(7)6-4(2-10)5(8)9/h4,10H,2H2,1H3,(H,6,7)(H,8,9)/t4-/m0/s1 checkY
  • Key:PWKSKIMOESPYIA-BYPYZUCNSA-N checkY
  (verify)

Acetylcysteine, also known as N-acetylcysteine (NAC), is a medication that is used to treat paracetamol (acetaminophen) overdose, and to loosen thick mucus in individuals with cystic fibrosis or chronic obstructive pulmonary disease.[2] It can be taken intravenously, by mouth, or inhaled as a mist.[2] Some people use it as a dietary supplement.[7][8]

Common side effects include nausea and vomiting when taken by mouth.[2] The skin may occasionally become red and itchy with either form.[2] A non-immune type of anaphylaxis may also occur.[2] It appears to be safe in pregnancy.[2] For paracetamol overdose, it works by increasing the level of glutathione, an antioxidant that can neutralise the toxic breakdown products of paracetamol.[2] When inhaled, it acts as a mucolytic by decreasing the thickness of mucus.[9]

Acetylcysteine was initially patented in 1960 and came into medical use in 1968.[10][11] It is on the World Health Organization's List of Essential Medicines.[12] It is available as a generic medication and is inexpensive.[13] Guidance on its use varies between countries.[13]

References[edit]

  1. ^ Stockley, Robert A. (2008). Chronic Obstructive Pulmonary Disease a Practical Guide to Management. Chichester: John Wiley & Sons. p. 750. ISBN 9780470755280. Archived from the original on 8 September 2017.
  2. ^ a b c d e f g h i j k l "Acetylcysteine". The American Society of Health-System Pharmacists. Archived from the original on 23 September 2015. Retrieved 22 August 2015.
  3. ^ "ACETADOTE (acetylcysteine) injection, solution [Cumberland Pharmaceuticals Inc.]". DailyMed. Cumberland Pharmaceuticals Inc. June 2013. Archived from the original on 13 January 2014. Retrieved 8 November 2013.
  4. ^ "L-Cysteine, N-acetyl- - Compound Summary". PubChem Compound. USA: National Center for Biotechnology Information. 25 March 2005. Identification. Archived from the original on 12 January 2014. Retrieved 9 January 2012.
  5. ^ a b Cite error: The named reference sial was invoked but never defined (see the help page).
  6. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 3 November 2020. Retrieved 22 September 2020.
  7. ^ Talbott, Shawn M. (2012). A Guide to Understanding Dietary Supplements. Routledge. p. 469. ISBN 9781136805707. Archived from the original on 8 September 2017.
  8. ^ "Cysteine". University of Maryland Medical Center. Archived from the original on 1 July 2017. Retrieved 23 June 2017.
  9. ^ Sadowska, Anna M; Verbraecken, J; Darquennes, K; De Backer, WA (December 2006). "Role of N-acetylcysteine in the management of COPD". International Journal of Chronic Obstructive Pulmonary Disease. 1 (4): 425–434. doi:10.2147/copd.2006.1.4.425. ISSN 1176-9106. PMC 2707813. PMID 18044098.{{cite journal}}: CS1 maint: unflagged free DOI (link)
  10. ^ Fischer, János; Ganellin, C. Robin (2006). Analogue-Based Drug Discovery. Weinheim: Wiley-VCH. p. 544. ISBN 9783527607495. Archived from the original on 8 September 2017.
  11. ^ US patent 3091569, Aaron Leonard Sheffner, "Mucolytic-nu-acylated sulfhydryl compositions and process for treating animal mucus", published 1963-05-28, issued 1963-05-28, assigned to Mead Johnson & Co 
  12. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  13. ^ a b Hitchings, Andrew; Lonsdale, Dagan; Burrage, Daniel; Baker, Emma (2019). The Top 100 Drugs: Clinical Pharmacology and Practical Prescribing (2nd ed.). Elsevier. pp. 30–31. ISBN 978-0-7020-7442-4. Archived from the original on 22 May 2021. Retrieved 9 November 2021.
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