Acetaminophen overdose.
Administration of anesthesia for procedure.
Atelectasis, Due to mucous obstruction.
Bronchopulmonary disease, acute.
Complication of surgical procedure - Respiratory complication.
Cystic fibrosis, Pulmonary complications; Adjunct.
Diagnostic procedure on lower respiratory tract.
Disease of respiratory system, chronic.
Tracheostomy care.

Acetaminophen overdose: Acetylcysteine acts as a hepatoprotective agent by restoring hepatic glutathione, serving as a glutathione substitute, and enhancing the nontoxic sulfate conjugation of acetaminophen.
Mucolytic: Exerts mucolytic action through its free sulfhydryl group which opens up the disulfide bonds in the mucoproteins thus lowering mucous viscosity.
Prevention of contrast-induced nephropathy (off-label use): The presumed mechanism in preventing contrast-induced nephropathy is its ability to scavenge oxygen-derived free radicals and improve endothelium-dependent vasodilation.

Distribution:
Vd: 0.47 L/kg
Metabolism:
Hepatic: Rapid and extensive deacetylation to cysteine or oxidation to diacetylcysteine
Excretion:
Renal: 0.21 L/hour/kg ; about 30% of total body clearance
Dialyzable: Yes (hemodialysis) 51%; Yes (continuous venovenous hemofiltration) 14.06%
Elimination Half Life:
Adults: 5.6 hours,newborns: 11 hours

Hypersensitivity to acetylcysteine
Specific contraindications have not been determined for the oral effervescent tablets

Fetal risk cannot be ruled out. (TH)

Infant risk cannot be ruled out.(MDX)

Common:
Dermatologic: Pruritus (1% to 3% ), Rash (4% to 5% ), Urticaria
Gastrointestinal: Diarrhea, Nausea (2% to 7% ), Vomiting (9% to 12% )
Serious:
Cardiovascular: Decreased cardiac function, Electrocardiogram abnormal, Hypervolemia
Immunologic: Anaphylactoid reaction (0.1% to 0.2% ), Hypersensitivity reaction (Adult, 8% to 18%; pediatric, 10% )
Neurologic: Status epilepticus
Respiratory: Bronchospasm, Respiratory distress

Acetaminophen overdose:
In patients weighing >40 kg
21-hour regimen: Consists of 3 doses; total dose delivered: 300 mg/kg
Loading dose: 150 mg/kg (maximum: 15 g) infused over 1 hour
Second dose: 50 mg/kg (maximum: 5 g) infused over 4 hours
Third dose: 100 mg/kg (maximum: 10 g) infused over 16 hours
In patients who weigh >100 kg
21-hour regimen: Consists of 3 doses; total dose delivered: 30 g
Loading dose: 15 g infused over 1 hour
Second dose: 5 g infused over 4 hours
Third dose: 10 g infused over 16 hours
The fluid volume should be reduced in patients weighing ?40 kg
Adjuvant therapy in respiratory conditions:
Inhalation, nebulization (face mask, mouth piece, tracheostomy):
Acetylcysteine 10% and 20% solution (dilute 20% solution with sodium chloride or sterile water for inhalation); 10% solution may be used undiluted: 3 to 5 mL of 20% solution or 6 to 10 mL of 10% solution until nebulized given 3 to 4 times/day; dosing range: 1 to 10 mL of 20% solution or 2 to 20 mL of 10% solution every 2 to 6 hours
Inhalation, nebulization (tent, croupette):
Dose must be individualized; may require up to 300 mL solution/treatment
Direct instillation:
Into tracheostomy: 1 to 2 mL of 10% to 20% solution every 1 to 4 hours
Through percutaneous intratracheal catheter: 1 to 2 mL of 20% or 2 to 4 mL of 10% solution every 1 to 4 hours via syringe attached to catheter.
Diagnostic bronchogram:
Nebulization or intratracheal: 1 to 2 mL of 20% solution or 2 to 4 mL of 10% solution administered 2 to 3 times prior to procedure (UTD)

Acetaminophen overdose: Infants, Children, and Adolescents: Refer to adult dosing.
Adjuvant therapy in respiratory conditions:
Inhalation, nebulization (face mask, mouth piece, tracheostomy): Acetylcysteine 10% and 20% solution (dilute 20% solution with sodium chloride or sterile water for inhalation); 10% solution may be used undiluted.
Infants: 1 to 2 mL of 20% solution or 2 to 4 mL 10% solution until nebulized given 3 to 4 times/day
Children: Refer to adult dosing.
Inhalation, nebulization (tent, croupette): Children: Refer to adult dosing. (UTD)