Mucolytics pharmacology

PRESENTATION ON MUCOLYTICS

1. MUCOLYTICS Presented by: Ms. ANJALI [BSc.(Hons) NURSING 2 nd YEAR]

2. TABLE OF CONTENTS 1 INTRODUCTION DEFINITION PHARMACOKINETICS PHARMACODYNAMICS PHARMACOTHERAPEUTICS 2 ACETYL CYSTEINE NAME CLASS MECHANISM OF ACTION 3 USES INDICATIONS CONTRAINDICATIONS DOSAGE ADVERSE EFFECTS 04 NURSING CONSIDERATIONS NURSING INTERVENTIONS PATIENT TEACHING

3. MUCOLYTICS Mucolytics act directly on mucus, breaking down sticky, thick secretions so they’re easier to eliminate.

4. PHARMACOKINETICS NOSE Inhalation LUNGS Absorption LIVER Metabolism

5. PHARMACODYNAMICS Acetyl cysteine decreases the thickness of respiratory tract secretions by altering the molecular composition of mucus. It also irritates the mucosa to encourage clearance .

6. PHARMACOTHERAPEUTICS Mucolytics are used with other therapies to treat patients with abnormal or thick mucous secretions. They may benefit patients with bronchitis, pulmonary complications of cystic fibrosis, or atelectasis caused by mucous obstruction , which may occur in pneumonia, bronchiectasis, or chronic bronchitis. These drugs may also be used to prepare patients for bronchial studies. However, they require cautious use in some patients.

7. PREGNANCY CATEGORY B DRUG CLASSE: Mucolytic CHEMICAL NAME: N- Acetyl cysteine GENERIC NAME: Acetyl cysteine TRADE NAME : Acetadote ACETYL CYSTEINE

8. 3,950,000 Big numbers catch your audience’s attention STRUCTURE

9. Splits links in the mucoproteins contained in respiratory mucus secretions, decreasing the viscosity of the mucus. THERAPEUTIC ACTION

10. MECHANISM OF ACTION INHALED Exerts its mucolytic action through FREE SULPHYDRYL GROUP Reduces the di- sulphide Bonds in the mucus matrix REDUCE DI-SULPHIDE BONDS Lowers the viscosity DECREASES VISCOSCITY mucolytic action achieved

11. INDICATIONS ● Mucolytic adjuvant therapy for abnormal, viscid, or mucus secretions in acute and chronic Broncho pulmonary disease . (emphysema with bronchitis, asthmatic bronchitis, tuberculosis, pneumonia, primary bronchiectasis, lung amyloidosis), in pulmonary complications of cystic fibrosis, and in tracheostomy care; pulmonary complications associated with surgery, anesthesia, post-traumatic chest conditions; diagnostic bronchial studies)

12. Available forms : solution of 10%, 20%, inj. 200mg/ml Nebulization with face mask can be done With 3-5ml of 20% or 6-10ml of 10% TID or QID.

13. SIDE EFFECTS GI TRACT NAUSEA STOMATITIS HYPERSENTIVITY URTICARIA RESPIRATORY BRONCHOSPASM ESPECIALLY IN PATIENTS WITH ASTHMA

14. ● Dilute the 20% acetyl cysteine solution with either normal saline or sterile water for injection; use the 10% solution undiluted. ● Administer the following drugs separately, because they are incompatible with acetyl cysteine solutions: Tetracycline, erythromycin , amphotericin B, iodized oil chymotrypsin, trypsin, hydrogen peroxide. ● Use water to remove residual drug solution on the patient’s face after administration by face mask. NURSING RESPONSIBILITIES

15. PATIENT EDUCATION! ● Inform patient that nebulization may produce an initial disagreeable odor , but the odor will soon disappear you may experience these side effects: Increased productive cough, nausea, GI upset Advise the patient not to perform activities that require alertness. Show the patient how to use and maintain the nebulizer. Teach the patient and family how to avoid contamination of acetyl cysteine solution. Tell them that the solution may discolor to a light purple, but is still usable . Instruct the patient and his family to refrigerate an open vial and to discard it after 4 days. Stress the importance of gargling after treatment to relieve the drug’s odor . Inform the patient about effective coughing before and after each treatment . Teach him and his family to perform chest physiotherapy and postural drainage after acetyl cysteine administration. Teach the patient to recognize signs and symptoms of stomatitis and, if they occur, to manage them appropriately

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