Most patients with bronchospasm are quickly relieved by the use of a bronchodilator given by nebulization. The converse is also true patients who have had inhalation treatments of acetylcysteine without incident may still react to a subsequent inhalation with increased airways obstruction. Even when patients are known to have reacted previously to the inhalation of an acetylcysteine aerosol, they may not react during a subsequent treatment. Those patients who are reactors cannot be identified a priori from a random patient population. Occasionally, patients exposed to the inhalation of an acetylcysteine aerosol respond with the development of increased airways obstruction of varying and unpredictable severity. Significant mucolysis occurs between pH 7 and 9.Īcetylcysteine undergoes rapid deacetylation in vivo to yield cysteine or oxidation to yield diacetylcystine. The mucolytic activity of acetylcysteine is unaltered by the presence of DNA, and increases with increasing pH. This group probably 'opens' disulfide linkages in mucus thereby lowering the viscosity. The mucolytic action of acetylcysteine is related to the sulfhydryl group in the molecule. The latter increases with increasing purulence owing to the presence of cellular debris. The viscosity of pulmonary mucous secretions depends on the concentrations of mucoprotein and, to a lesser extent, deoxyribonucleic acid (DNA). Related/similar drugs acetylcysteine, ambroxol, Mucinex DM, Robitussin Cough + Chest Congestion DM, dextromethorphan / guaifenesin, Tussin DM, Acys-5 Mucomyst - Clinical Pharmacology

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