Antibiotic acetine

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Acetine

international and chemical name: acetylcysteine, -2-acetamido-3-mercaptopropanoic acid;

Main physical and chemical characteristics: white granular powder;

Composition 1 package of the drug contains 100 or 200 mg of acetylcysteine;

Table of contents:

other ingredients: ascorbic acid, sodium saccharinate, sucrose, beta-carotene, anhydrous colloidal silicon dioxide, sodium bicarbonate, sodium benzoate.

Release form of the medicine. Granules.

Pharmacotherapeutic group. Medicines used for coughs and colds. Mucolytic agents. ATS R05C B01.

· Pharmacodynamics. Mucolytic drug. It thins sputum, increases its quantity and facilitates its secretion and thus promotes expectoration. The effect of acetylcysteine ​​is associated with the ability of its sulfhydryl groups to break the disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolarization of mucoproteins and a decrease in mucus viscosity. Remains active in the presence of purulent sputum. It has an antioxidant effect due to the presence of an SH group that can interact with and neutralize electrophilic oxide toxins. Acetylcysteine ​​helps increase the synthesis of glutathione, which is an important antioxidant factor in intracellular protection and provides support for the functional activity and morphological integrity of the cell.

· Pharmacokinetics. After internal use, it is well absorbed from the gastrointestinal tract. Significantly experiences a “first pass” effect through the liver, which leads to decreased bioavailability. Binds to plasma proteins by 50% after 4 hours. after internal use. Metabolized in the liver and possibly in the intestinal wall. In plasma it is determined unchanged, as well as in the form of metabolites - N-acetylcysteine, N, N-diacetylcysteine ​​and cysteine ​​ester. Renal clearance accounts for 30% of the total clearance.

Indications for use. Respiratory diseases and conditions that are accompanied by the formation of viscous and mucopurulent sputum: acute and chronic bronchitis, tracheitis due to bacterial and/or viral infection, pneumonia, bronchiectasis, bronchial asthma, atelectasis due to blockage of the bronchi with a mucus plug, sinusitis (to facilitate removal secretion), cystic fibrosis (as part of combination therapy). Removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions. Used in case of paracetamol overdose (no later than the first hour).

Method of use and dose. The dose is set individually. In adults and children over 14 years of age, the daily dose of Acetine is mg, taken 4-6 times 100 mg or 200 mg 2-3 times a day; in children aged 6 to 14 years - 200 mg 2 times a day or 100 mg 4 times a day; in children aged 2 to 6 years, the daily dose of Acetine is mg, which should be taken 100 mg 2-3 times a day. Children under 2 years of age can use Acetine after the 10th day of life only for health reasons under the constant supervision of a doctor. The recommended daily dose for infants is 50 mg, 50 mg 2-3 times a day.

Acetine is recommended to be taken after meals. To do this, before using the drug, you need to dissolve the contents of the package in a small amount of water, iced tea juice (ml) and drink the resulting suspension. Additional use of water, juices or teas after taking the suspension enhances the mucolytic properties of Acetine.

The duration of treatment depends on the nature and course of the disease. As a rule, the course of treatment is 1-2 weeks; with tracheobronchitis of the day. Treatment of chronic diseases is carried out in courses of several months (up to 6 months).

Side effect. From the digestive system: rarely - heartburn, nausea, vomiting, diarrhea, feeling of fullness in the stomach.

Allergic reactions: rarely - skin rash, itching, urticaria, bronchospasm. Others: rarely - nosebleeds, tinnitus.

Contraindications. Peptic ulcer of the stomach and/or duodenum in the acute phase, hemoptysis, pulmonary hemorrhage, increased sensitivity to the components of the drug.

Overdose. Until this time, no cases of severe and life-threatening consequences of an overdose of Acetine have been identified, even in conditions of extreme overdose.

Symptoms of overdose may be: nausea, vomiting, skin rash, itching, vascular edema, bronchospasm, tachycardia, hypo- or hypertension.

Treatment: symptomatic, gastric lavage followed by the use of activated charcoal and antiemetics. There is no specific antidote.

Features of use. Pregnancy and lactation. Adequate and well-controlled clinical studies of the safety of the use of acetylcysteine ​​during pregnancy and breastfeeding have not been conducted. During pregnancy and breastfeeding, Acetine can be used only if the predicted benefit to the mother outweighs the potential risk to the fetus or child.

Acetine is used with caution in patients with bronchial asthma, diseases of the liver, kidneys, and adrenal glands. When using Acetin in patients with bronchial asthma, it is necessary to ensure sputum drainage. In infants and children under 2 years of age, Acetine is used only for health reasons at a dose of 10 mg/kg under the constant supervision of a physician. Between the use of Acetin and antibiotics, it is necessary to adhere to intervals of 1-2 hours.

In places of possible contact with acetylcysteine ​​solution, it is necessary to use parts made from the following materials: glass, plastic, aluminum, chromed metal, tantalum, silver or stainless steel. After contact, silver may darken, but this does not affect the effectiveness of acetylcysteine ​​and does not harm the patient's health.

Interaction with other drugs. With the simultaneous use of Acetin with antitussives, it is possible to increase stagnation of sputum through inhibition of the cough reflex. When used simultaneously with antibiotics (including tetracycline, ampicillin, amphotericin B), their interaction with the thiol group of acetylcysteine ​​is possible.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Tetracycline antibiotics (with the exception of doxycycline) are not recommended to be taken simultaneously with Acetine. Also, taking Acetin and oral use of antibiotics should not coincide. The interval between their doses should be at least 2 hours. In vitro, incompatibility with semisynthetic penicillins, tetracyclines, cephalosporins, and aminoglycosides has been noted.

The simultaneous use of nitroglycerin and Acetin can lead to an increase in the vasodilatory effect of nitroglycerin.

Store in a dry place, protected from light and out of reach of children, at a temperature not exceeding 20°C.

Source: http://polyntrava.ru/lekarstva/protivoprostudnye/acetin.html

Acetylcysteine ​​- instructions for use, analogs, reviews and release forms (effervescent tablets, powder 100 mg, 200 mg and 600 mg, solution for inhalation and rinsing) medications for the treatment of cough with sputum in adults, children and pregnancy. Compound

In this article you can read the instructions for use of the drug Acetylcysteine. Reviews of site visitors - consumers of this medicine, as well as the opinions of specialist doctors on the use of Acetylcysteine ​​in their practice are presented. We kindly ask you to actively add your reviews about the drug: whether the medicine helped or did not help get rid of the disease, what complications and side effects were observed, perhaps not stated by the manufacturer in the annotation. Acetylcysteine ​​analogues in the presence of existing structural analogues. Use for the treatment of bronchitis, pneumonia and other diseases accompanied by cough with sputum in adults, children, as well as during pregnancy and lactation. Composition of the drug.

Acetylcysteine ​​is a mucolytic agent and is a derivative of the amino acid cysteine. It has a mucolytic effect, facilitates the discharge of sputum due to a direct effect on the rheological properties of sputum. The action is due to the ability to break the disulfide bonds of mucopolysaccharide chains and cause depolymerization of sputum mucoproteins, which leads to a decrease in sputum viscosity. The drug remains active in the presence of purulent sputum.

It has an antioxidant effect due to the ability of its reactive sulfhydryl groups (SH groups) to bind to oxidative radicals and thus neutralize them.

In addition, acetylcysteine ​​promotes the synthesis of glutathione, an important component of the antioxidant system and chemical detoxification of the body. The antioxidant effect of acetylcysteine ​​increases the protection of cells from the damaging effects of free radical oxidation, which is characteristic of an intense inflammatory reaction.

With the prophylactic use of acetylcysteine, there is a decrease in the frequency and severity of exacerbations in patients with chronic bronchitis and cystic fibrosis.

Acetylcysteine ​​+ excipients.

When taken orally, it is well absorbed from the gastrointestinal tract. Substantially undergoes first pass effect through the liver, resulting in decreased bioavailability. Binding to plasma proteins up to 50% (4 hours after oral administration). Metabolized in the liver and possibly in the intestinal wall. In plasma it is determined unchanged, as well as in the form of metabolites - N-acetylcysteine, N,N-diacetylcysteine ​​and cysteine ​​ester. Renal clearance accounts for 30% of the total clearance.

Respiratory diseases and conditions accompanied by the formation of viscous and mucopurulent sputum:

  • acute and chronic bronchitis;
  • tracheitis due to bacterial and/or viral infection;
  • pneumonia;
  • bronchiectasis;
  • bronchial asthma;
  • atelectasis due to blockage of the bronchi by mucus plug;
  • sinusitis (to facilitate the passage of secretions);
  • cystic fibrosis (as part of combination therapy).

Removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions.

Effervescent tablets 200 mg and 600 mg.

Powder for solution for oral administration 100 mg and 200 mg.

Solution for inhalation.

Instructions for use and dosage regimen

Inside. Adults - 200 mg 2-3 times a day in the form of granules, tablets or capsules.

Children 2-6 years old - 200 mg 2 times a day or 100 mg 3 times a day in the form of a water-soluble granulate; younger than 2 years mg 2 times a day; 6-14 years mg 2 times a day.

For chronic diseases for several weeks: adults mg per day in 1-2 doses; children 2-14 years old mg 3 times a day; for cystic fibrosis - children from 10 days to 2 years - 50 mg 3 times a day, 2-6 years mg 4 times a day, over 6 years mg 3 times a day in the form of a water-soluble granulate, effervescent tablet or in capsules.

Inhalation. For aerosol therapy, 20 ml of a 10% solution or 2-5 ml of a 20% solution are sprayed in ultrasound devices; in devices with a distribution valve - 6 ml of a 10% solution. Duration of inhalation minutes; frequency: once a day. When treating acute conditions, the average duration of therapy is days; for long-term therapy of chronic conditions, the course of treatment is up to 6 months. In the case of a strong secretolytic effect, the secretion is sucked out, and the frequency of inhalations and the daily dose are reduced.

Intratracheal. To wash the bronchial tree during therapeutic bronchoscopy, use a 5-10% solution.

Locally. Instill into the nasal passages (for 1 procedure).

Parenterally. Administer intravenously (preferably drip or slow stream over 5 minutes) or intramuscularly. Adults - 300 mg 1-2 times a day.

Children from 6 to 14 years old - 150 mg 1-2 times a day. For children under 6 years of age, oral administration is preferable; for children under 1 year of age, intravenous administration of acetylcysteine ​​is possible only for health reasons in a hospital setting. If there are still indications for parenteral therapy, the daily dose for children under 6 years of age should be 10 mg/kg body weight.

For intravenous administration, the solution is further diluted with 0.9% NaCl solution or 5% dextrose solution in a 1:1 ratio.

The duration of therapy is determined individually (no more than 10 days). In patients over 65 years of age, the minimum effective dose is used.

  • heartburn;
  • nausea, vomiting;
  • diarrhea;
  • feeling of fullness in the stomach;
  • skin rash;
  • itching;
  • hives;
  • bronchospasm;
  • with shallow intramuscular injection and in the presence of increased sensitivity, a slight and quickly passing burning sensation may appear, and therefore it is recommended to inject the drug deep into the muscle;
  • reflex cough;
  • local irritation of the respiratory tract;
  • stomatitis;
  • rhinitis;
  • nosebleeds;
  • noise in ears;
  • a decrease in prothrombin time due to the administration of large doses of acetylcysteine ​​(monitoring the state of the blood coagulation system is necessary);
  • changes in the results of the salicylate quantitation test (colorimetric test) and ketone quantitation test (sodium nitroprusside test).
  • peptic ulcer of the stomach and duodenum in the acute phase;
  • hemoptysis;
  • pulmonary hemorrhage;
  • pregnancy;
  • lactation period (breastfeeding);
  • hypersensitivity to acetylcysteine.

Use during pregnancy and breastfeeding

The use of Acetylcysteine ​​is contraindicated during pregnancy and lactation (breastfeeding).

When using acetylcysteine ​​in patients with bronchial asthma, it is necessary to ensure sputum drainage. In newborns, it is used only for health reasons at a dose of 10 mg/kg under the strict supervision of a physician.

Orally for children over 6 years old - 200 mg 2-3 times a day; children aged 2 to 6 years - 200 mg 2 times a day or 100 mg 3 times a day, up to 2 years - 100 mg 2 times a day.

Acetylcysteine ​​is used with caution in patients with bronchial asthma, diseases of the liver, kidneys, and adrenal glands.

A 1-2 hour interval should be observed between taking acetylcysteine ​​and antibiotics.

Acetylcysteine ​​reacts with some materials such as iron, copper and rubber used in the spray device. In places of possible contact with acetylcysteine ​​solution, parts made of the following materials should be used: glass, plastic, aluminum, chromed metal, tantalum, sterling silver or stainless steel. Silver may tarnish after contact, but this does not affect the effectiveness of acetylcysteine ​​and does not harm the patient.

The simultaneous use of acetylcysteine ​​with antitussives may increase sputum stagnation due to suppression of the cough reflex.

When used simultaneously with antibiotics (including tetracycline, ampicillin, amphotericin B), their interaction with the thiol group of acetylcysteine ​​is possible.

When taking acetylcysteine ​​and nitroglycerin simultaneously, the vasodilator and antiplatelet effects of the latter may be enhanced.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Pharmaceutically incompatible with solutions of other drugs. On contact with metals and rubber, it forms sulfides with a characteristic odor.

Analogues of the drug Acetylcysteine

Structural analogues of the active substance:

  • N-AC-ratiopharm;
  • N-acetylcysteine;
  • Acestine;
  • Acetylcysteine ​​Canon;
  • Acetylcysteine ​​Teva;
  • Acetylcysteine ​​solution for inhalation 20%;
  • Acetylcysteine ​​solution for injection 10%;
  • Acetylcysteine ​​PS;
  • ACC;
  • ACC injection;
  • ACC Long;
  • AC-FS;
  • Vicks Active ExpectoMed;
  • Mukobene;
  • Mucomist;
  • Mukonex;
  • Fluimucil;
  • Exomyuk 200;
  • Espa-Nat.

Analogs by pharmacological group (secretolytics):

  • Marshmallow syrup;
  • Ambrobene;
  • Ambroxol;
  • Ambrosan;
  • Ambrosol;
  • Ascoril;
  • Bromhexine;
  • Bronchicum;
  • Bronchicum inhalate;
  • Bronchicum cough lozenges;
  • Bronchicum cough syrup;
  • Bronchipret;
  • Bronchostop;
  • Bronchotil;
  • Gedelix;
  • Hexapneumin;
  • GeloMyrtol;
  • Herbion primrose syrup;
  • Herbion plantain syrup;
  • Glycyram;
  • Chest collection;
  • Breast Elixir;
  • Joset;
  • Dr. MOM;
  • Dr. Theiss syrup with plantain;
  • Zedex;
  • Insti;
  • Carbocysteine;
  • Cashnol;
  • Codelac Broncho;
  • Coldact Broncho;
  • Coldrex broncho;
  • Lazolvan;
  • Libexin Muco;
  • Linkas;
  • Mukaltin;
  • Mucosol;
  • Expectorant collection;
  • Pectosol;
  • Pectusin;
  • Pertussin;
  • overslept;
  • Rinicold Broncho;
  • Sinupret;
  • Mixture for inhalation;
  • Licorice syrup;
  • Solutan;
  • Stoptussin;
  • Cough tablets;
  • Terpinhydrate;
  • Travisil;
  • Tussamag;
  • Tussin;
  • Tussin Plus;
  • Fervex for cough;
  • Flavamed;
  • Flavamed forte;
  • Fluifort;
  • Fluditek;
  • Halixol;
  • Erdostein.

Source: http://instrukciya-otzyvy.ru/1467-acetilcistein-po-primeneniyu-analogi-tabletki-shipuchie-poroshok-rastvor-ingalyacii.html

ACC or Acetylcysteine ​​- a detailed description of the legendary drug, facts and misconceptions.

ACC (Acetylcysteine) promotes liquefaction and abundant secretion of sputum, as a result of which the cough is softened, and sputum is easier to expectorate and is removed from the body, freeing the lungs and bronchi. This effect of Acetylcysteine ​​is a consequence of its destructive (mucolytic) effect on the structure of mucopolysaccharides responsible for the viscosity of sputum.

Before you continue reading: If you are looking for an effective method of getting rid of a runny nose, pharyngitis, tonsillitis, bronchitis or colds, then be sure to look at this section of the site after reading this article. This information has helped so many people, we hope it will help you too! So, now back to the article.

In addition, Acetylcysteine ​​is characterized by a mild antiseptic effect, immunomodulatory and hepatoprotective (restoring the structure of liver cells) activity.

Recently, Acetylcysteine ​​solution is often prescribed for the treatment of mental illness: the drug is believed to have a mild psychotropic effect.

Indications. For what diseases is Acetylcysteine ​​used?

Acetylcysteine, which is no less known as ACC, is actively used for inhalation and injection in adults and children. Indications for prescribing the medicine:

  • Acute bronchitis
  • Chronic bronchitis, including obstructive
  • Bronchiectasis
  • Bronchial asthma complicated by irreversible bronchial obstruction
  • Cystic fibrosis
  • Pneumonia (lung inflammation)
  • Other respiratory diseases in which coughing is difficult due to increased viscosity of sputum

Help with coughs with sticky sputum. Inhalations and injections

Cough is the body’s protective reaction to irritation of the mucous membrane of the upper respiratory tract. This irritation can be caused by foreign objects, e.g. a person coughs because he has choked. We also cough, inhaling suffocating gases and toxic fumes.

However, the most common causes of cough, for which the administration of Acetylcysteine ​​inhalations to children and adults (and its ingestion) is indicated, are allergic and infectious diseases, as a result of which an inflammatory process develops in the mucous membrane of the larynx, trachea, bronchi and lungs, accompanied by the release of mucus - sputum.

PS For effective inhalations you need a good inhaler. How to choose the right inhaler for inhalation? - a very useful article, don’t be lazy to read! This article also explains how to do inhalations and many other important and interesting nuances.

Sputum during bronchitis can vary in nature, composition and consistency. Transparent liquid sputum is usually easily coughed up, but bronchitis is often accompanied by the release of viscous sputum, which clogs the lungs and bronchi and leads to worsening of the disease.

In this case, the cough becomes painful and the sputum becomes purulent, which is a bad prognostic sign. If bronchitis is complicated by bronchiectasis (dilation of sections of the bronchi), in which viscous purulent sputum accumulates in large quantities, a solution (Acetylcysteine) can be prescribed by injection - intramuscular or intravenous.

In addition, a solution for parenteral administration is prescribed for cystic fibrosis, a severe hereditary lung disease accompanied by a violation of their physiological state and breathing problems.

Synonyms and name variations

Persistent cough requires complex drug treatment, one of the components of which is drugs from the group of mucolytics. It is to this group of drugs that Acetylcysteine ​​belongs (synonyms for the drug name N-Acetylcysteine, N-acetyl-L-cysteine, the abbreviated form of the name is ACC).

Synonyms of the drug also include commercial names of drugs such as Inspir, Acetein, Broncholysin, Airbron, Broncholysin, Fluimucil, Mucosolvin, Mucoluticum, Mucomyst, Racomex, etc. Some of these drugs include excipients, but each of them contains N -Acetylcysteine ​​is the main active component.

Antibiotic Acetylcysteine: a myth that has no relation to reality

If you are offered to buy the antibiotic Acetylcysteine ​​“at a reasonable price”, do not do this for two reasons.

Firstly, you can only buy any medicine at a pharmacy, public or private (licensed).

Secondly, the antibiotic Acetylcysteine ​​is a non-existent drug, because the drug is not an antibiotic in its structure and mode of action, and does not have a bactericidal effect.

Acetylcysteine ​​alone can cure an infectious disease without an antibiotic. However, in case of viscous purulent sputum, when prescribing an antibacterial agent, the doctor will definitely prescribe Acetylcysteine ​​or another mucolytic in combination with an antimicrobial drug in order to speed up its action and enhance the effect.

N-Acetylcysteine ​​in combination with tuaminoheptane: actions and indications

Among the most effective complex preparations with a mucolytic effect, which includes ACC, is a spray for irrigation of the nose and throat acetylcysteine ​​+ tuaminoheptane.

In combination with acetylcysteine, tuaminoheptane is used to treat inflammatory diseases of the upper respiratory tract, as well as for inhalation for bronchitis and pneumonia.

Once in the lungs, these substances act in combination: acetylcysteine ​​thins sputum, tuaminoheptane has a vasoconstrictor effect and reduces the formation of mucus.

It should be borne in mind that tuaminoheptane is a beta blocker, and therefore its action may cause undesirable effects in some patients. Therefore, in some cases, the drug Acetylcysteine ​​for inhalation is used in isolation.

If the dosage, frequency of procedures and duration of treatment are observed, the drug in its pure form does not cause any significant side effects.

Acetylcysteine ​​is available for inhalation in ampoules. After opening the ampoule, the solution may change color, which is normal.

Is Acetylcysteine ​​prescribed for children with bronchitis?

Acetylcysteine ​​is prescribed to children, and very actively, due to its safety and high effectiveness. As a rule, for children over three years of age the drug is prescribed by inhalation. For children under 3 years of age, the injection option is more recommended.

The fact is that a small child is not always able to expectorate on his own, and after inhalation this must be done. Otherwise, the baby may simply choke on the abundant phlegm.

Which is better: Acetylcysteine ​​or Ambroxol?

It is difficult to answer this question. Acetylcysteine, Ambroxol and other mucolytics, acting on one principle or another, reduce the amount of mucopolysaccharides in the secretion, as a result of which the sputum becomes liquid and abundant, it is easier to cough up and the lungs are freed from purulent contents.

Moreover, each medicine has additional effects, based on which the doctor prescribes this or that drug for the treatment of bronchitis, its complications, as well as other diseases of the upper respiratory tract accompanied by cough.

One of the advantages of Ambroxol is its low price compared to the price of Acetylcysteine. At the same time, although Ambroxol is much cheaper, anyone can also afford to buy Acetylcysteine: this highly effective medicine is far from the most expensive.

The price is quite affordable

Despite the unique capabilities, the cost of the drug Acetylcysteine ​​is low. However, there are cheaper medications with similar effects.

So, if price is a determining factor for you when purchasing Acetylcysteine, you can discuss with your doctor the possibility of replacing it, for example, with Ambroxol.

However, remember that such a replacement is not always indicated, and carefully study the instructions for Acetylcysteine ​​and the instructions for another drug from the mucolytic group if you are offered to buy it at a pharmacy in the absence of the first one.

If Acetylcysteine ​​is affordable for you, it is not recommended to change your doctor’s prescriptions on your own or experiment with medications.

The average price of the drug is rubles.

The article above and comments written by readers are for informational purposes only and do not encourage self-medication. Consult a specialist regarding your own symptoms and illnesses. When taking any medicine, you should always use the instructions that come with the medicine and your doctor's advice as a guide.

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Do you want to get rid of your nose, throat, lung and cold diseases? Then be sure to check it out here.

It is also worth paying attention to other drugs for bronchitis and cough:

ACC powder is sold in pharmacies in sachets, to which the seller does not attach an annotation. And it says that this drug is incompatible with antibiotics, other antitussives, and nitroglycerin. After ACC, ANY medications can be taken no earlier than 2 hours later.

2. The fact that even a child cannot drink all medications in one slide is clear; the drugs interact with each other, so the interval between doses is at least 2 hours!

3. ACC is a mucolytic (it thins sputum and weakly removes it!), and antitussives inhibit the cough center, i.e., they are used when there is pathologically NO sputum - this begs the question: why combine them?

I have bronchitis, is it possible to combine ACC with Berodual *n?

Join, speak out and discuss. Your opinion may be very important to many readers!

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Source: http://cc-t1.ru/preparaty/acetilcistein.html

ACETINE

Instructions for medical use of the drug ACETIN

international and chemical names: acetylcysteine, ® -2-acetamido-3-mercaptopropanoic acid;

Basic physical and chemical properties : granular white powder;

Composition: 1 sachet contains 100 mg or 200 mg of acetylcysteine;

excipients: sucrose, sodium bicarbonate, anhydrous colloidal silicon dioxide, ascorbic acid, sodium benzoate, sodium saccharinate, beta-carotene.

Release form. Granules.

Pharmacotherapeutic group. Medicines used for coughs and colds. Mucolytic agents.

ATS code R05СВ01.

Pharmacodynamics. Mucolytic, expectorant, derivative of the amino acid cysteine. Due to the presence of a free sulfhydryl group, acetylcysteine ​​breaks the disulfide bonds of acidic mucopolysaccharides in sputum, which leads to depolymerization of mucoproteins and helps reduce the viscosity of bronchial secretions. Facilitates sputum discharge due to increased mucociliary clearance. Remains active in the presence of purulent sputum. It has antioxidant and pneumoprotective effects due to the ability of sulfhydryl groups to neutralize free radicals and reactive oxygen metabolites, which are responsible for the development of acute and chronic inflammation in the lung tissue and airways. Acetylcysteine ​​helps increase the synthesis of glutathione, which is an important detoxification factor. This property of acetylcysteine ​​makes it possible to use it as an antidote for acute poisoning with paracetamol and other substances (aldehydes, phenols and others). Promotes the safe elimination of cyclophosphamide metabolites - acrolein. The effect when taken orally begins within 30 – 90 minutes. and lasts 2 – 4 hours.

Pharmacokinetics. After oral administration, acetylcysteine ​​is quickly and almost completely absorbed from the digestive tract. In the liver it is metabolized to cysteine ​​(pharmacological active metabolite) and diacetylcystine, cystine and further to mixed disulfides. The bioavailability of acetylcysteine ​​when taken orally is approximately 10% (due to the high “first pass” effect through the liver). The maximum concentration is reached after 1 – 3 hours. In the body, acetylcysteine ​​and its metabolites are determined in various forms: partly as a free substance, partly in connection with blood plasma proteins (approximately 50%), partly as incorporated amino acids. It is excreted almost completely in the form of inactive metabolites (inorganic sulfates, diacetylcystine) in the urine. Only a small amount of acetylcysteine ​​is excreted unchanged in feces. The half-life from blood plasma is approximately 1 hour. and depends on the rate of biotransformation in the liver. In case of liver failure, it can increase to 8 hours. Acetylcysteine ​​can cross the placental barrier and accumulate in the amniotic fluid.

Indications for use. Respiratory diseases and conditions accompanied by the formation of viscous and mucopurulent sputum: acute and chronic bronchitis, tracheitis due to bacterial and/or viral infection, pneumonia, bronchiectasis, bronchial asthma, sinusitis (to facilitate the removal of secretions), cystic fibrosis (as part of a combination therapy). Removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions. Used in case of paracetamol overdose (no later than the first 8 – 15 hours).

Method of administration and dose. Apply orally after meals, having previously dissolved the contents of the package in a small amount of water, juice or iced tea (50 - 100 ml). Additional use of water, juices or teas after taking the suspension enhances the mucolytic properties of Acetine.

The dose is set individually. In adults and children over 14 years of age, the daily dose of Acetine is 400–600 mg, taken 4–6 times 100 mg or 200 mg 2–3 times a day; in children aged 6 to 14 years – 300–400 mg 2 times a day or 100 mg once a day; in children aged 2 to 6 years, the daily dose of Acetine is 200–300 mg, which should be taken 100 mg 2–3 times a day.

For cystic fibrosis, patients weighing more than 30 kg may be prescribed a dose of up to 800 mg/day. Children over 6 years old are usually prescribed 200 mg 3 times a day, 2 - 5 years old - 100 mg 4 times a day, newborns (from the 10th day of life) and children under 2 years of age are prescribed 50 mg 2 - 3 once a day.

For children under 2 years of age, Acetin can be used only for health reasons under the constant supervision of a doctor, starting from the 10th day of life.

The duration of treatment depends on the nature and course of the disease. As a rule, the course of treatment is 1 – 2 weeks; for tracheobronchitis – 3 – 4 days. Treatment of chronic diseases is carried out in courses of several months (up to 6 months).

Side effect. From the digestive system: rarely - heartburn, nausea, vomiting, diarrhea, feeling of fullness in the stomach.

Allergic reactions: rarely - skin rashes, itching, urticaria, bronchospasm. Other: rarely - nosebleeds, tinnitus, headache, stomatitis, arterial hypotension, tachycardia.

Contraindications. Peptic ulcer of the stomach and/or duodenum in the acute phase, hemoptysis, pulmonary hemorrhage, hypersensitivity to the components of the drug.

Overdose. So far, no cases of severe and life-threatening consequences of an overdose of Acetine have been identified, even in conditions of extreme overdose.

Symptoms: nausea, vomiting, skin rashes, itching, vascular edema, bronchospasm, tachycardia, arterial hypo- or hypertension.

Treatment: symptomatic, gastric lavage followed by the use of activated charcoal and antiemetics. There is no specific antidote.

Features of application. Between the use of Acetine and antibiotics, intervals of 1 to 2 hours must be observed.

Acetine is used with caution in patients with bronchial asthma, diseases of the liver, kidneys, and adrenal glands. When using Acetine in patients with bronchial asthma, it is necessary to ensure sputum drainage. Use for purulent bronchitis and cystic fibrosis should be combined with active evacuation of sputum; for obstructive bronchitis (with caution) - with bronchodilators. If there is no therapeutic effect after a week of therapy, you should consult a doctor.

In areas of possible contact with acetylcysteine ​​solution, parts made of the following materials should be used: glass, plastic, aluminum, chromed metal, tantalum, silver or stainless steel. After contact, the silver may darken, but this does not affect the effectiveness of acetylcysteine ​​and does not harm the patient's health.

Pregnancy and breastfeeding. Adequate and well-controlled clinical studies of the safety of acetylcysteine ​​during pregnancy and lactation have not been conducted. During pregnancy and breastfeeding, Acetine can be used only if the expected benefit to the mother outweighs the potential risk to the fetus or child.

Impact on the ability to drive vehicles or operate complex machinery. Unknown.

Help for patients with diabetes.

1 sachet of 100 mg acetylcysteine ​​contains 0.24 bread units; 1 sachet with 200 mg of acetylcysteine ​​contains 0.23 bread units.

Interaction with other drugs. It is not recommended to take Acetin simultaneously with tetracycline antibiotics (with the exception of doxycycline). The interval between taking them should be at least 2 hours. In vitro incompatibility with semisynthetic penicillins, cephalosporins, and aminoglycosides has been determined. There is no evidence of incompatibility with antibiotics such as amoxicillin, erythromycin and cefuroxime.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

The simultaneous use of nitroglycerin and Acetin can lead to an increase in the vasodilating effect of nitroglycerin.

Acetine increases (mutually) the effect of bronchodilators. When Acetin is used simultaneously with antitussives, a dangerous accumulation of sputum in the respiratory tract is possible due to suppression of the cough reflex.

Storage conditions. Store out of the reach of children at a temperature not exceeding 25 ºС. Shelf life – 2 years.

Key words: acetine instructions, acetine use, acetine composition, acetine reviews, acetine analogues, acetine dosage, medicine acetine, acetine price, acetine instructions for use.

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Acetylcysteine

Content

Structural formula

Russian name

Latin name of the substance Acetylcysteine

Chemical name

N-Acetyl-L-cysteine ​​(as sodium salt)

Gross formula

Pharmacological group of the substance Acetylcysteine

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Acetylcysteine

White or white with a slightly yellowish tint crystalline powder, with a slight specific odor. Easily soluble in water and alcohol; The pH of a 20% aqueous solution is 7–7.5.

Pharmacology

Due to the presence of a free sulfhydryl group, it breaks the disulfide bonds of acidic mucopolysaccharides of sputum, inhibits the polymerization of mucoproteins and reduces the viscosity of mucus.

It thins sputum and significantly increases its volume (in some cases, suction is required to prevent “flooding” of the lungs). It has a stimulating effect on mucosal cells, the secretion of which is lysed by fibrin. Increases glutathione synthesis and activates detoxification processes. It has anti-inflammatory properties due to the suppression of the formation of free radicals and reactive oxygen metabolites responsible for the development of acute and chronic inflammation in the lung tissue and airways.

When taken orally, it is well absorbed, but the bioavailability is low - no more than 10% (during the “first pass” through the liver it is deacetylated to form cysteine), Cmax is achieved after 1–3 hours. Plasma protein binding is about 50%. Penetrates the placental barrier and is found in amniotic fluid. T1 /2 when taken orally is 1 hour, with liver cirrhosis it increases to 8 hours. It is excreted mainly by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine), a small part is excreted unchanged by the intestines.

Application of the substance Acetylcysteine

Difficulty secreting sputum (bronchitis, tracheitis, bronchiolitis, pneumonia, bronchiectasis), cystic fibrosis, lung abscess, emphysema, laryngotracheitis, interstitial lung diseases, bronchial asthma, pulmonary atelectasis (due to blockage of the bronchi with a mucus plug), catarrhal and purulent otitis media, sinusitis, incl. sinusitis, removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions, paracetamol poisoning (as an antidote).

Contraindications

Hypersensitivity, peptic ulcer of the stomach and duodenum in the acute stage.

Restrictions on use

Peptic ulcer of the stomach and duodenum, varicose veins of the esophagus, hemoptysis, pulmonary hemorrhage, phenylketonuria, bronchial asthma without thickening of sputum, diseases of the adrenal glands, arterial hypertension, liver and/or kidney failure.

Use during pregnancy and breastfeeding

During pregnancy, it is possible if the expected effect of therapy exceeds the potential risk to the fetus.

FDA category of effect on the fetus is B.

Breastfeeding should be stopped during treatment.

Side effects of the substance Acetylcysteine

From the gastrointestinal tract: nausea, vomiting, heartburn, feeling of fullness in the stomach, stomatitis.

Allergic reactions: skin rash, itching, urticaria, bronchospasm (mainly in patients with bronchial hyperreactivity).

Other: drowsiness, fever; rarely - tinnitus; reflex cough, local irritation of the respiratory tract, rhinorrhea (for inhalation use); burning at the injection site (for parenteral use).

Interaction

The simultaneous use of acetylcysteine ​​and antitussives may increase sputum stagnation due to suppression of the cough reflex (should not be used simultaneously). When used together with antibiotics, such as tetracyclines (excluding doxycycline), ampicillin, amphotericin B, they may interact with the thiol SH group of acetylcysteine, which leads to a decrease in the activity of both drugs (the interval between taking acetylcysteine ​​and antibiotics should be at least 2 hours) . When taking acetylcysteine ​​and nitroglycerin simultaneously, the vasodilator and antiplatelet effects of the latter may be enhanced. Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol. Pharmaceutically incompatible with solutions of other drugs. On contact with metals and rubber, it forms sulfides with a characteristic odor.

Routes of administration

Inside, intravenously, intramuscularly, inhalation, endobronchially, locally.

Precautions for the substance Acetylcysteine

In patients with broncho-obstructive syndrome (develops quite often against the background of increased bronchospasm), acetylcysteine ​​must be combined with bronchodilators.

Interactions with other active ingredients

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Acetylcysteine

acetylcysteine) together with rimantadine?

It’s better to try starting with herbal expectorant syrups; there are quite a few of them in pharmacies. But you can also try using drugs such as Acetylcysteine ​​(ACC), Bromhexine or the like.

Of course, the contraindications given in the drug instructions and individual tolerance should be taken into account.

However, it is better to stop smoking or at least reduce smoking.

Tell me, is it possible to take ACC if you are injecting ceftriaxone? IN

the instructions for the ACC say that the ACC is not compatible with

tetracycline, so they should be taken orally no earlier than after

2 hours after taking acetylcysteine.

ACC interaction: enhances the vasodilator and other effects of nitroglycerin. Incompatible with cough suppressants (possible accumulation of mucus in the respiratory tract). Reduces the absorption of penicillins, cephalosporins, tetracycline, erythromycin (an interval of 2 hours between doses is required). There is no interaction information regarding thiazole derivatives (SULBUTIAMINE). I think ACC will not destroy sulbutiamine.

Sulbutiamine is rapidly absorbed from the gastrointestinal tract, the maximum concentration is achieved 1-2 hours after administration. If in doubt, take your medications at different times or find an alternative to ACC.

The information provided is intended for medical and pharmaceutical professionals, should not be used for treatment and cannot be considered as official. The most accurate information about the drug is contained in the instructions supplied with the packaging by the manufacturer. No information posted on this or any other page of our website can serve as a substitute for personal contact with a specialist.

Please pay attention to the specified dates for entering information; information may become outdated.

Source: http://www.webapteka.ru/drugbase/name740.html

ACETYL CYSTEINE

Mucolytic agent is a derivative of the amino acid cysteine. It has a mucolytic effect, increases the volume of sputum, facilitates its discharge due to a direct effect on the rheological properties of sputum. The action of acetylcysteine ​​is associated with the ability of its sulfhydryl groups to break intra- and intermolecular disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolarization of mucoproteins and a decrease in sputum viscosity. Remains active in the presence of purulent sputum.

Increases the secretion of less viscous sialomucins by goblet cells, reduces the adhesion of bacteria to the epithelial cells of the bronchial mucosa. Stimulates mucous cells of the bronchi, the secretion of which is lysed by fibrin. It has a similar effect on the secretions formed during inflammatory diseases of the ENT organs.

It has an antioxidant effect due to the ability of its reactive sulfhydryl groups (SH groups) to bind to oxidative radicals and thus neutralize them.

Acetylcysteine ​​easily penetrates into the cell and is deacetylated to L-cysteine, from which intracellular glutathione is synthesized. Glutathione is a highly reactive tripeptide, a powerful antioxidant and cytoprotector that neutralizes endogenous and exogenous free radicals and toxins. Acetylcysteine ​​prevents exhaustion and helps increase the synthesis of intracellular glutathione, which is involved in the redox processes of cells, promoting the detoxification of harmful substances. This explains the effect of acetylcysteine ​​as an antidote for paracetamol poisoning.

Protects alpha1-antitrypsin (elastase inhibitor) from the inactivating effects of HOCl, an oxidizing agent produced by myeloperoxidase of active phagocytes. It also has an anti-inflammatory effect (by suppressing the formation of free radicals and reactive oxygen-containing substances responsible for the development of inflammation in the lung tissue).

When taken orally, it is well absorbed from the gastrointestinal tract. It is largely subject to the “first pass” effect through the liver, which leads to a decrease in bioavailability. Binding to plasma proteins up to 50% (4 hours after oral administration). Metabolized in the liver and possibly in the intestinal wall. In plasma it is determined unchanged, as well as in the form of metabolites - N-acetylcysteine, N,N-diacetylcysteine ​​and cysteine ​​ester.

Renal clearance accounts for 30% of the total clearance.

Respiratory diseases and conditions accompanied by the formation of viscous and mucopurulent sputum: acute and chronic bronchitis, tracheitis due to bacterial and/or viral infection, pneumonia, bronchiectasis, bronchial asthma, atelectasis due to blockage of the bronchi with a mucus plug, sinusitis (to facilitate the passage of secretions ), cystic fibrosis (as part of combination therapy).

Preparation for bronchoscopy, bronchography, aspiration drainage.

Removal of viscous secretions from the respiratory tract in post-traumatic and postoperative conditions.

For washing abscesses, nasal passages, maxillary sinuses, middle ear, treatment of fistulas, surgical field during operations on the nasal cavity and mastoid process.

Peptic ulcer of the stomach and duodenum in the acute phase, hemoptysis, pulmonary hemorrhage, pregnancy, lactation (breastfeeding), hypersensitivity to acetylcysteine.

Contraindications for use in children under 14 years of age depend on the dosage form and are indicated in the instructions for use of the drug used.

Orally for adults and children over 6 years old - 200 mg 2-3 times a day; children aged 2 to 6 years - 200 mg 2 times / day or 100 mg 3 times / day, up to 2 years - 100 mg 2 times / day.

Parenteral: IM for adults - 300 mg 1 time/day, for children - 150 mg 1 time/day.

Administer intravenously (preferably drip or slow stream over 5 minutes) or intramuscularly. Adults - 300 mg 1-2 times/day; children from 6 to 14 years old - 150 mg 1-2 times a day. The daily dose for children under 6 years of age is 10 mg/kg body weight; in children under 1 year of age, intravenous administration of acetylcysteine ​​is possible only for health reasons in a hospital setting. The duration of treatment should be determined based on changes in the patient's condition.

For inhalation and intratracheal use, the dose, frequency of use and course duration are set individually.

Locally - instilled into the external auditory canal and nasal passages (1.5-3 ml) for 1 procedure.

From the digestive system: rarely - heartburn, nausea, vomiting, diarrhea, feeling of fullness in the stomach.

Allergic reactions: rarely - skin rash, itching, urticaria, bronchospasm.

With shallow intramuscular injection and in the presence of increased sensitivity, a slight and quickly passing burning sensation may appear, and therefore it is recommended to inject the drug deep into the muscle.

When used by inhalation: reflex cough and local irritation of the respiratory tract are possible; rarely - stomatitis, rhinitis.

Other: rarely - nosebleeds, tinnitus.

From the laboratory parameters: a decrease in prothrombin time is possible due to the administration of large doses of acetylcysteine ​​(monitoring the state of the blood coagulation system is necessary), changes in the results of the test for the quantitative determination of salicylates (colorimetric test) and the test for the quantitative determination of ketones (sodium nitroprusside test).

The simultaneous use of acetylcysteine ​​with antitussives may increase sputum stagnation due to suppression of the cough reflex.

When used simultaneously with antibiotics (including tetracycline, ampicillin, amphotericin B), their interaction with the thiol group of acetylcysteine ​​is possible.

Acetylcysteine ​​reduces the hepatotoxic effect of paracetamol.

Use with caution in the following diseases and conditions: history of gastric and duodenal ulcers; bronchial asthma, obstructive bronchitis; liver and/or kidney failure; histamine intolerance (long-term use should be avoided, since acetylcysteine ​​affects the metabolism of histamine and can lead to signs of intolerance, such as headache, vasomotor rhinitis, itching); varicose veins of the esophagus; adrenal gland diseases; arterial hypertension.

When using acetylcysteine ​​in patients with bronchial asthma, it is necessary to ensure sputum drainage. In newborns, it is used only for health reasons at a dose of 10 mg/kg under the strict supervision of a physician.

A 1-2 hour interval should be observed between taking acetylcysteine ​​and antibiotics.

Acetylcysteine ​​reacts with some materials such as iron, copper and rubber used in the spray device. In places of possible contact with acetylcysteine ​​solution, parts made of the following materials should be used: glass, plastic, aluminum, chromed metal, tantalum, sterling silver or stainless steel. Silver may tarnish after contact, but this does not affect the effectiveness of acetylcysteine ​​and does not harm the patient.

The compliance of the route of administration and the dosage form used should be strictly observed.

Contraindicated for use during pregnancy and lactation (breastfeeding).

When using acetylcysteine ​​in patients with bronchial asthma, it is necessary to ensure sputum drainage. In newborns, it is used only for health reasons at a dose of 10 mg/kg under the strict supervision of a physician.

Orally for children over 6 years old - 200 mg 2-3 times a day; children aged 2 to 6 years - 200 mg 2 times / day or 100 mg 3 times / day, up to 2 years - 100 mg 2 times / day.

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Source: http://health.mail.ru/drug/acetylcysteine/