Benefits on Usage of Mucolytics

Type of Drug:

Respiratory inhalant, drug that thins mucus.

How the Drug Works:

Acetylcysteine decreases the thickness and stickiness of mucus secretions of the lung, making them easier to cough up, and therefore promoting removal (expectoration) of this fluid.

Dornase alfa decreases the thickness and stickiness of mucus secretions of cystic fibrosis patients.

Uses:

Acetylcysteine: To treat abnormally thick mucus secretions in chronic emphysema, emphysema with bronchitis, chronic asthmatic bronchitis, tuberculosis, bronchiectasis (chronic dilation of the airways), pneumonia, bronchitis, tacheobronchitis, cystic fibrosis, and other conditions involving excess mucus accumulation in the lung that is significant enough to affect breathing.

To reduce abnormally thick mucus secretion during tracheostomy care and diagnostic bronchial tests (eg, bronchograms, bronchospirometry, bronchial wedge catheterization).

To reduce abnormally thick mucus secretions during anesthesia in or after surgery or chest injuries.

As an emergency oral antidote drug to decrease liver damage after acetaminophen (eg, Tylenol) poisoning.

Dornase alfa: To reduce frequency of respiratory infections requiring parenteral (injectable) antibiotics and to improve pulmonary function in conjunction with standard therapies for patients with cystic fibrosis.

Unlabeled Uses: Occasionally, doctors may prescribe acetylcysteine as an eye solution to treat severe dry eyes or as an enema to treat bowel obstruction.

Precautions:

Do not use in the following situations: Allergy to acetylcysteine, dornase alfa, Chinese hamster ovary cell products (dornase alfa only), or any other ingredients within the drug.

Prolonged use: Safety and effectiveness of daily administration of dornase alfa for longer than 12 months have not been established.

Pregnancy: There are no adequate or well-controlled studies in pregnant women. Use only if clearly needed and the potential benefits to the mother outweigh the possible hazards to the fetus.

Breastfeeding: It is not known if acetylcysteine or dornase alfa appear in breast milk. Consult your doctor before you begin breastfeeding.

Children: Safety and effectiveness of dornase alfa in children younger than 5 years of age have not been established.

Side Effects:

Every drug is capable of producing side effects. Many mucolytic users experience no, or minor, side effects. The frequency and severity of side effects depend on many factors including dose, duration of therapy, and individual susceptibility. Possible side effects include:

Respiratory System: Increased mucus; runny nose; sore throat; voice changes; voice loss; cough; difficulty breathing; bronchitis; bronchspasm (spasm of the air tubes); chest tightness.

Digestive Tract: Nausea; vomiting; stomach pain; mouth inflammation.

Other: Fever; rash; drowsiness; eye inflammation; clamminess.

Guidelines for Use:

• Dosage is individualized. Take exactly as prescribed.

• Do not stop taking or change the dose unless directed by your doctor.

• If a dose is missed, inhale it as soon as possible. If several hours have passed or it is nearing time for the next dose, do not double the dose to catch up, unless advised to do so by your doctor. If more than one dose is missed or it is necessary to establish a new dosage schedule, contact your doctor or pharmacist.

• Discontinue therapy if symptoms of allergy appear, unless symptoms can be controlled with other drugs and therapy is considered essential.

• Inform your doctor if you are pregnant, become pregnant, plan on becoming pregnant, or are breastfeeding.

• Do not mix other drugs in the nebulizer unless advised to do so by your doctor.

• Only administer with equipment provided by, or recommended by, your doctor.

• Acetylcysteine - Follow dilution and administration techniques taught by your doctor. When used to treat acetaminophen poisoning, it will be prepared and administered by a health care professional in a medical setting. May produce an increased volume of Liquefied secretions that must be coughed up. Notify your doctor if you have difficulty coughing up these secretions. May initially produce a slight disagreeable odor which soon disappears. May cause a stickiness on the face after nebulization with a face mask. This can be easily removed by washing with water. Color of the solution may change in the opened bottle, but the light purple color does not significantly reduce the drug's safety or effective­ ness if used within 96 hours after opening. The 20% solution may be diluted with either Normal Saline, Water for Injection, or Sterile Water for inhalation. The 10% solution may be used undiluted. Continued nebulization of acetylcysteine with a dry gas results in concentration of the drug in the nebulizer due to evaporation. This may reduce nebulization and drug delivery. Dilute with Sterile Water for Injection as concentration Occurs. Store unopened vial at controlled room temperature (59° to 86°F). Store unused portion in refrigerator once opened and use within 96 hours.

• Dornase alfa - The recommended dose is one 2.5 mg single-use ampule inhaled once daily using a recommended nebulae. Some patients may benefit from twice daily administration. Use in conjunction with standard therapies for cystic fibrosis. Discard solution if it is cloudy or discolored. dronasa alfa contains no preservatives; therefore, once opened, the entire ampule must be used or discarded. Do not dilute or mix dornase with other drugs in the nebulizer. Store in protective foil pouch under refrigeration (36° to 46°F). Protect from light. Do not use beyond the expiration date.