Making Acetylcysteine bearable?

[kaliRN]

Any suggestions or tricks? Administered by nebulizer as a respiratory treatment, not orally.

Thanks in advance. It seems this is the only mucolytic administered via HHN.

[POTR]

Eh, I tend to subscribe to the "Disraeli/Mark Twain" theory on studies/statistics, at least when money is involved.

(There are three kinds of lies... )

Acetylcysteine has had quite a few studies, one shows a very low bioavailability orally...

Bystol-Meyers Squibb DOES recommend mixing their version with non-specific DIET-soda to a very specific ratio.

However:

1. they do not list any of the normal components of any soda on their very specific "Compatible/Incompatible" list.

2. they do mention that the effective ph range for their product is between 7.0 and 9.0

3. the ph spectrum of sodas runs from approx 2.49 (Pepsi (3.05 - Pepsi One)) to 4.61 (Barqs - (4.55 - Diet))

So... it only 'works' in a neutral to base envelope... let's suggest mixing it with a non-specified moderate acid of unknown composition to get people to choke it down so we can sell more. Sounds like a plan.

And as far as the effects of soda without Acetylcycteine... Sodas have already been shown to have the effects I've mentioned on COPDer's, as well as adversely affect the acid/base profile of CO2 retainers. You could also even check your own O2 and respirations before, during and after consumption to see some of the effects soda will cause for you and how long it takes you to recover from those effects, or ask an AE-C what they know about the subject.

[CoffeeRTC, BSN, RN]

I dunno...we give it and just open the window a bit. Thats about all you can do.

[Esme12, ASN, BSN, RN]

Eh, I tend to subscribe to the "Disraeli/Mark Twain" theory on studies/statistics, at least when money is involved.

(There are three kinds of lies... )

Acetylcysteine has had quite a few studies, one shows a very low bioavailability orally...

Bystol-Meyers Squibb DOES recommend mixing their version with non-specific DIET-soda to a very specific ratio.

However:

1. they do not list any of the normal components of any soda on their very specific "Compatible/Incompatible" list.

2. they do mention that the effective ph range for their product is between 7.0 and 9.0

3. the ph spectrum of sodas runs from approx 2.49 (Pepsi (3.05 - Pepsi One)) to 4.61 (Barqs - (4.55 - Diet))

So... it only 'works' in a neutral to base envelope... let's suggest mixing it with a non-specified moderate acid of unknown composition to get people to choke it down so we can sell more. Sounds like a plan.

And as far as the effects of soda without Acetylcycteine... Sodas have already been shown to have the effects I've mentioned on COPDer's, as well as adversely affect the acid/base profile of CO2 retainers. You could also even check your own O2 and respirations before, during and after consumption to see some of the effects soda will cause for you and how long it takes you to recover from those effects, or ask an AE-C what they know about the subject.

I for one have never seen a COPD, CO2 retainer have adverse affects from ingesting carbonated beverages. NOt to deny that it is possible. I agree that they usually are very fragile in their balance to breathe. As with anything in medicine it is a benefit versus risk senario. Mucomist is to be given orally only for a very specific set of circumstances. If tylenol overdose is the issue, it is probably more medically prudent to utilize the IV administration protocol for saftey and effecacy.

If in the presence of "off label" use in the presence of renal insuff. The goal is the ph, acid base, anion gap changes that are the basis of treatment, benefit versus risk. As always.....monitor your patient closely in the event of adverse effects stop Rx immediately and notify appropriately. Medical trreatments vary greatly across the United States. I have worked in large teaching facilities that do not believe in HHN even on ventilated patients and MDI's are utilized for in-line treatment with use of mucumist non existant. Go figure..........unfortunately mucomist smells like rotten eggs....it will probably always smell like rotten eggs. It is a great mucolytic and is useful in medicine. I have always felt sorry for the non vented patients who had to smell it with HHN. I have personally used a little vicks and a mask for a variety of odiferous smells!