Mucomyst iv

[msn2008]

One of our interventionists ordered mucomyst 1200mg iv if available on a patient post heart cath with elevated BUN and creatinine. The pharmacy did not sent iv, only the usual po dose, which was the physician's second choice. I've heard the docs talking about using mucomyst iv, but I can't find any printed info on this. Is anyone else using mucomyst iv for renal function? Any links to literature?

Thanks in advance.

[Noryn]

You can give PO Mucomyst IV, it is done quite often in my state. A pharmacist needs to mix it under a sterile hood and then when it is administered it needs to have a special filter. Run it kind of slow for the first 30 minutes then if there is no reaction you can turn it up a bit. This dosing is for Tylenol overdoses and if they are unable to keep the PO mucomyst down.

Loading dose is same as PO, 140mg/kg then 70mg/kg maintenance dose for 17 doses.

There is also acetadote which is an IV form however the dosing is different. The most important thing is to make sure you have the right filter something like a .22mcg. Also if you give the PO form IV make sure you have an order and have everyone like pharmacy included in the plan.

[Morettia2, BSN, RN]

ok I have given mucomyst PO a million times, it stinks like a bad perm, BUT one of my first days as a new RN on post interventional cardiac the dr. ordered it IVP so i gave it, the preceptor screamed at me NO NO PO...I said No it says IVP in the orders..little did she know th BUN and Creat were off the charts...pt has RHC with too much contrast dye, Bicarb was already running..haha I will never forget that..

[Spatialized]

I've heard (and seen) it for tylenol OD, but renal protection post-cath is a new one. Very interesting. Usually the docs order it PO, with a bicarb drip. Hmmm...have to file that one away. Thanks!

Tom

[PICC ACE]

Have seen it ordered by both routes,for renal protection,OD's and liver transplants.

One odd thing is that in some countries you can get it in a berry or punch-flavored powdered mix that has no rotten egg taste at all. Do a search for 'Fluimucil'. It's a popular OTC mucolytic.

[suni, BSN, RN]

Is the information aboujt the filter in the package insert? I have given it IV but just used our regular pump tubing?

[Noryn]

Is the information aboujt the filter in the package insert? I have given it IV but just used our regular pump tubing?

It depends on what you are using. PO Mucomyst is not FDA approved for IV use (I dont think) so the insert will not tell you this. The filter will catch impurities. When giving PO Mucomyst via IV for acetaminophen overdoses you can also give it the same as Acetadote. 150 mg/kg hr-50 mg/kg 4 hours then 100 mg/kg 16 hours.

Now there is an IV form of Mucomyst specifically for IV use called Acetadote. It is much more expensive and does not need to be filtered.