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Acetylcysteine

Synonyms: N-acetylcysteine, N-acetyl-L-cysteine, NAC
Trade names: Acetadote®, Mucomyst®, Cetylev®

1 Definition

Acetylcysteine is mainly used as a paracetamol antidote and as a mucolytic.

2 Chemistry

Acetylcysteine has a molar mass of 163,20 g·mol−1. The molecular formula is C5H9NO3S.

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3 Mechanisms of Action

3.1 As an Antidote

The hepatic breakdown of paracetamol creates hepatotoxic compounds that are neutralised using glutathione. The biosynthesis of glutathione requires cysteine, which is provided by the acetylcysteine.

Acetylcysteine is most effective in paracetamol poisoning when administered within eight hours of paracetamol intake.

3.2 As a Mucolytic

Acetylcysteine has the ability to break down disulfide bonds between strands of glycosaminoglycans, contained in bronchial secretions formed during respiratory infections, thereby liquefying thick mucus and easing expectoration.

Because of acetylcysteine's mucolytic abilities it is mainly administered in patients suffering from respiratory diseases that produce thick bronchial mucus such as COPD, bronchitis, mucoviscidosis etc.

4 Confounding Effects

Acetylcysteine is found to have confounding effects in laboratory tests utilising the Trinder test. Creatinine, cholesterol, lactate, uric acid and lipase values may be falsely low.

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