Acetylcysteine ​​for inhalation is used in pulmonology to treat NDP diseases. The drug with an instant effect is injected aerosol through an inhaler. For the nebulizer, the ACC injection solution is used.

Instructions for the use of acetylcysteine ​​are studied before inhalation. Mucolytic, interacting with phlegm, has a direct effect on its viscosity. The phlegm becomes more liquid, flowing. The substance promotes the conversion of polymeric mucoproteins into monomers.

The epithelium is resistant to negative external factors, including infection. ACC is effective regardless of the pathogenesis of sputum. The solution used for the inhaler acts as an antioxidant. It helps to neutralize and detoxify free radicals. At the same time, it ensures the elimination of toxins. If severe inflammation occurs, the drug prevents cell damage.

On a note! ACC can be used to prevent the development of a bacterial infectious process. The procedure prevents the development of complications in patients suffering from chronic pathology of DS.

Release form

With the help of ACC, inhalation therapy provides a quick sputum discharge. The drug can be purchased in tablet form or in granules. For inhalation, Fluimucil (Acetylcysteine) is used.

This tool is a clear solution, which is available in ampoules with a dosage of 5 ml. Main components inhalation solution are:

• disodium edetate;
• sodium hydroxide.

Indications for use of acetylcysteine

Indications for use of Acetylcysteine ​​- effective solution for inhalation:

• bronchitis of various pathogenesis;
• tracheitis;
• asthma;
• cystic fibrosis.

With the help of this therapy, it is possible to remove sputum during the rehabilitation period after surgery, when the patient is lying.

Contraindications

Doctors identify the following contraindications for inhalations with ACC:

• aggravated ulcer;
• tuberculosis;
• bleeding in the bronchi;
• asthma with normal secretion.

If, against the background of the therapy, the patient develops a reaction, a new treatment is prescribed. With the appearance of shortness of breath, tracheal stenosis and rhinitis, the procedures are stopped. The patient is prescribed a desensitizing agent.

Acetylcysteine ​​for inhalation can be used by pregnant women, but after consultation with a gynecologist and therapist. Long-term procedures require regular monitoring of the liver and kidneys. The patient needs to be tested for enzymes.

Mode of application

If nebulizer therapy is prescribed for an adult patient, then 3 manipulations per day are performed with 3 ml of Acetylcysteine ​​solution for inhalation. The duration of one session is 15 minutes. Patients at risk should adhere to the treatment regimen.

The dosage of the drug varies according to the age of the patient, while the proportion of 1: 1 is observed. Children aged 2-6 years are prescribed 1 ml of the drug and saline. Children aged 6-12 years are prescribed 2 ml of ACC and saline. It is recommended that adolescents be given 3 ml of the main drug and saline.

Important! Children of any age are not recommended to do more than 2 sessions a day. If the child is not prescribed enhanced treatment for complications that have arisen, it is recommended to dilute the main drug according to the standard scheme. In this case, the dosage may increase or the number of procedures performed per day may increase.

In the acute course of the disease, treatment lasts up to 10 days. If the patient's condition has improved, the symptoms have disappeared, therapy does not stop. In case of bronchitis or pneumonia, it is recommended to take laboratory tests. If identified chronic pathology, the treatment lasts six months with interruptions. With prolonged pneumonia, periodic inpatient treatment is indicated.

ACC is indicated for admission if the cough is dry and severe. If sputum flows normally, inhalation is contraindicated. Otherwise, the volume of sputum will increase, which can provoke prolonged vomiting.

During the course of therapy, it is necessary to observe the annotation to the medication. Improper manipulation can aggravate the disease, provoking complications. If Acetylcysteine ​​is diluted in proportion, the patient's condition will improve.

Side effects

Uncontrolled intake of inhalation solution is prohibited. An overdose can provoke nausea, and drug particles can cause a cough. It is recommended to rinse after the session oral cavity to prevent stomatitis.

In the treatment of ENT - diseases characterized by the formation of a large amount of mucus in the bronchi and at the same time its poor discharge, mucolytics are prescribed - drugs that have a destructive effect on mucopolysaccharides that impart viscosity to sputum.

Acetylcysteine ​​solution, better known as ACC, is often used in the form of inhalation for adults and children.

In view of the fact that Acetylcysteine ​​is prescribed for the treatment of children from birth, the most popular form due to the reduced effect on the excretory organs is the dosage form in the form of a solution for inhalation.

Pills

Compared to the use in tablet form or in the form of syrups, the solution used for inhalation with a nebulizer allows you to instantly deliver active substances to the diseased organ and provide a therapeutic effect practically without side effects in the form of irritation of the gastric mucosa.

10% solution

For inhalations, a solution is released with an active substance concentration of 10% in ampoules of 2 ml and 20%, 5 and 10 ml each.

In addition, in pharmacies you can find a solution for intravenous and intramuscular injections, which are not suitable for inhalation.

Indications for use

Acetylcysteine ​​solution for inhalation is prescribed to children with diseases of ENT - organs accompanied by poor sputum discharge, such as:

• Acute and chronic bronchitis
• Bronchial asthma
• Tracheitis
• Laryngotracheitis
• Pneumonia
• Cystic fibrosis
• Emphysema of the lungs
• Lung atelectasis
• Bronchiectasis disease

Inhalation with the drug Acetylcysteine ​​solution 10% is also prescribed for sinusitis with poor mucus discharge from the inflamed sinuses.

Pharmacodynamics

Acetylcysteine ​​belongs to the group of mucolytics, the main property of which is an increase in volume, due to the thinning of mucus, which contributes to its better expectoration. For this reason, the agent in the form of inhalation is prescribed for children under three years of age with caution and under the supervision of a doctor, due to the narrow respiratory tract and a high risk of obstruction.

The drug is prescribed for purulent sputum, since it has antiseptic properties, reducing the adhesion of microbes on the mucous surface of the bronchi.

Also, acetylcysteine ​​inhibits the formation of free radicals, has antioxidant properties and reduces inflammatory processes in the lung tissues.

How to apply

Acetylcysteine ​​solution is used in the form of inhalation using a compressor or electronic mesh nebulizer.

In a nebulizer

An ultrasonic nebulizer is not suitable for these purposes, since the complex structure of the drug is destroyed, which leads to the absence of a positive effect from the inhalation procedure.

For children

For inhalations for children, the solution is diluted with saline in a 1 to 1 ratio and poured into a nebulizer container. For one inhalation, the dosage is 1 - 2 ml of the drug for children under 6 years of age. For children aged 6 - 12 years, the dosage is 2 - 3 ml of a pure preparation, additionally diluted in half with saline. The duration of the procedure is 10 - 15 minutes.

The course of treatment depends on the purpose and can be from one week or more with chronic forms diseases.

Compatibility with other drugs

Acetylcysteine ​​is not compatible with other solutions drugs... With the simultaneous use of antibiotics, it reduces their absorption into the bloodstream and reduces the effectiveness of antibiotic therapy. For this reason, it is recommended to make an interval of at least 2 hours between taking these groups of medicines.

It is not advisable to combine it with the intake of nitroglycerin, as this will lead to a strong vasodilation. Also, a mucolytic reduces the hepatotoxic effect of paracetamol-based drugs.

Contraindications

It is prescribed with caution to children with bronchial asthma disease, while it is necessary to stay in the inpatient department of the hospital and ensure the patient has a good sputum discharge with the help of bronchodilators.

It is also undesirable for patients with diseases of the excretory systems, impaired kidney and liver function.

Side effects

The drug is well tolerated and in most cases does not cause side effects. Minor episodes of dizziness or nausea associated with drug overdose are possible.

When inhaled, there are rare cases of rhinitis, stomatitis caused by irritation of the mucous membrane. Allergic reactions are also possible in the form of skin rashes in case of allergy to components medicinal product... Acetylcysteine ​​is potent remedy, used in the case of severe diseases of the ENT organs. It is considered unacceptable to use a drug on its own without a doctor's prescription, as well as for prophylaxis.

Remain the safest and most effective way treatment of cough, removal of phlegm from the lungs. This treatment has practically no contraindications and side effects. Saline without added drugs is safe for people of all ages, including pregnant women.

Inhalation has been known for a long time. Many diseases were treated by inhalation of vapors. Until now, this method of cough treatment remains very effective. In some cases, this is the only one possible way cure, for example, in the first weeks when drugs cannot be taken, or in infancy, in the presence of allergies, etc.

Almost any type of cough, both dry and wet, can be treated with inhalation. For the greatest safety, the steam should be cold, not hot, that is, it is advisable to use a special device for inhalation ().

Indications for inhalations with saline, to which drugs can be added, if necessary, are respiratory diseases, inflammatory processes in the lungs and bronchi, viral and bacterial infections.

Despite the safety of this method, it has some contraindications.

Inhalation is not carried out during the acute period of the disease, as the patient's condition may worsen. As a rule, this procedure is prescribed for aftercare when the period of exacerbation has passed.

Contraindications for inhalation with saline:

• High body. Inhalation can raise the temperature even more, even if it is not heat inhalation. The body begins to intensify metabolic processes, so the body temperature will continue to rise. It is not recommended to do inhalation for people with a body temperature above 37.5 degrees.
• ... If there is bleeding from the nose, hemoptysis, an increased tendency to bleeding in general, inhalation should be abandoned. They dilate blood vessels and can increase bleeding.
• Allergic reaction. it is almost impossible to meet the saline solution, but if other drugs were added to the solution, they can provoke allergic reaction, increase swelling and cough.
• Severe diseases of the heart and blood vessels. Inhalation affects the vessels, can expand them to improve blood flow, but in some diseases this can lead to damage to the vessels and.

Useful video - Inhalation for a child: Lasolvan and sodium chloride.

How to cure a severe cough in a child? - Most best practices treatment

An infectious cough lasts up to two weeks, it appears during the day and gets worse at night, when a person is lying down and it is difficult to excrete phlegm. If a cough lasts more than two weeks, it is called chronic.The cough reflex does not always arise due to illness, sometimes it is the body's reaction to physiological factors, for example, to a pungent smell of perfume, to inhalation of odorless gas, to cigarette smoke ("smoker's cough"), to too cold or hot air, to dust into the respiratory tract.

Dry prolonged cough with hemoptysis is often observed with tumors of the respiratory organs. If at the same time arise painful sensations, we can talk about damage to the pleura.

Inhalation with saline: rules for implementation

Sodium chloride - saline solution for inhalation

Inhalation has many advantages over other cough suppressants. For example, when drugs are added to a saline solution, they are absorbed much faster and act more effectively than when drugs are taken orally.

When inhaled, the drugs act locally, without irritating the mucous membrane of the stomach and intestines. Vapors, when inhaled, enter directly into the respiratory tract, bronchi, lungs and quickly begin to act, thinning phlegm and promoting its excretion.

The absorption time of drugs is greatly reduced and the number of side effects is very few. When using exclusively sodium chloride solution (saline), side effects are completely absent. When using drugs, side effects appear depending on the body's response to the active substance.

There are certain rules for inhalation. If you follow them, you can significantly reduce side effects and increase the effectiveness of the procedure:

• It is not recommended to do inhalation before bedtime and immediately after meals. The best time for inhalation is the first half of the day, not earlier than 1.5 hours after a meal.
• not carried out uncontrollably, as with any medical procedure, dosage is important. It cannot be exceeded. There are special marks on the medication container in the nebulizer that allow you to dispense the medication.
• It is important to consider not only the dosage of the drug, but also the time of the procedure. Small children should not breathe steam for more than 3 minutes, adults - more than 7-10 minutes.
• When treating throat and respiratory diseases, it is advisable to breathe not only through the nose, but also through the mouth, and also alternate: inhale through the mouth, exhale through the nose and vice versa. This will greatly increase the effectiveness of the procedure.
• After each use, the inhalation mask, tube and container for the drug should be rinsed and, if possible, treated with alcohol.
• It is advisable to rest the irritated throat for about an hour after the procedure. You should try not to eat, drink, talk, or smoke.
• No oil preparations, essential oils can not be used in home nebulizers. They leave an oil film in the tubes and on the mask. Not all oils are good for coughs and can cause allergies.

Inhalation preparations

Correctly performing inhalations is the key to a quick recovery.

In the pharmacy you can find a huge number of preparations for inhalation in a nebulizer from different types... They differ in price active ingredients, effect, dosage. Prescribing drugs should only be the attending physician.

It is worth remembering that such drugs are not used in their pure form, they must be diluted with saline:

• ... Bronchodilator in the form of drops, designed specifically for inhalation. The drug is practically odorless. Berodual is prescribed for asthma, bronchitis. It is not recommended to take the drug during pregnancy and lactation. A few drops of the drug (for adults - up to 10 drops per application) are added to the saline solution and inhaled.
• Ambrobene. The drug is available in the form of an odorless solution for inhalation. This drug has a mucolytic effect, and it facilitates its excretion from the bronchi and lungs. It should not be taken at the same time as antitussive drugs. The dosage is determined depending on the age of the patient and the severity of the condition. Adults should not take more than 4 ml of the drug per day.
• Atrovent. This drug is prescribed for asthma and dry coughs. Contraindications include childhood up to 6 years old. During pregnancy and lactation, the drug is prescribed only on the recommendation of a doctor in case of emergency. Adults can use up to 20 drops of the drug per day.
• Sinupret. It is containing herbal extracts, released in the form of drops. It helps to strengthen general immunity and relieve swelling of the mucous membranes of the nose, throat, respiratory tract, bronchi. Sinupret enhances the effect of the treatment and viral diseases in young children, inhalation with saline is often used, as this is the most gentle and safe method of treatment. If you use only saline, there will be no side effects. Such inhalations can be done from six months.

  If different medicinal preparations, you should look in the instructions for the permissible age and consult your doctor.For convenience, the nebulizer kit includes a small mask for children. It is not recommended for adults.

  After each use, the mask must be thoroughly treated with alcohol.

  Small children under a certain age cannot swallow or dissolve. Here he comes to the rescue. Saline vapors penetrate deeply into the respiratory tract, bronchi, relieve inflammation, edema, thin phlegm, relieve cough and accelerate the healing process.

  Tips for parents:

  • The saline solution does not need to be boiled. If there is no nebulizer, then it only needs to be warmed up so that steam appears. Too hot steam can burn the mucous membranes of the throat and nose.
  • You can breathe saline for up to 15 minutes. If drugs were added to it, the maximum time is 5 minutes.
  • Immediately after inhalation, do not overcool the child. It is not recommended to go outside, eat or drink for at least an hour after the procedure.
  • It is believed that saline can be made by dissolving ordinary salt in water. For inhalation, it is better for a child to purchase sterile saline at a pharmacy. It is more efficient and safer.
  • The frequency of the procedure depends on the condition of the child. Inhalation can be carried out every day no more than 2 times a day. Do not use herbal infusions to treat a child. When added to an inhaler, they penetrate deep into the lungs, can cause severe allergic reactions and worsen the body's condition.
  • It is not recommended to use antitussives immediately after using inhalation with saline. Saline dilutes phlegm, it is excreted from the lungs using a cough reflex.

APPROVED BY

By order of the chairman
Medical and
pharmaceutical activities

Ministry of Health

Republic of Kazakhstan

From "_____" _______ 201

№ ______________

Instructions for medical use

medicinal product

FLUIMUCIL

Tradename

Fluimucil

International non-proprietary name

Acetylcysteine

Dosage form

Solution for injection and inhalation, 100 mg / ml, 3 ml

Composition

One ampoule contains

active substance- acetylcysteine ​​300 mg,

Excipients: disodium edetate, sodium hydroxide, water for injection.

Description

Transparent, colorless solution with a faint sulfur odor

Pharmacotherapeutic group

Expectorant drugs. Mucolytics.

ATC code R05CB01

Pharmacological properties

Pharmacokinetics

With intravenous administration of 600 mg of acetylcysteine, the maximum plasma concentration is 300 mmol / l, the half-life from plasma is 2 hours. The total clearance is 0.21 l / h / kg, and the volume of distribution at the plateau is 0.34 l / kg.

In the liver, it is deacetylated to cysteine. A mobile equilibrium of free and plasma protein-bound acetylcysteine ​​and its metabolites (cysteine, cystine, diacetylcysteine) is observed in the blood. Acetylcysteine ​​penetrates into the intercellular space, mainly distributed in the liver, kidneys, lungs, bronchial secretions.

It is excreted by the kidneys in the form of inactive metabolites (inorganic sulfates, diacetylcysteine), a small part is excreted unchanged through the intestines.

Penetrates the placental barrier.
Pharmacodynamics

Mucolytic agent, liquefies phlegm, increases its volume, facilitates the separation of phlegm. The action is associated with the ability of free sulfhydryl groups of acetylcysteine ​​to break intra- and intermolecular disulfide bonds of acidic mucopolysaccharides of sputum, which leads to depolymerization of mucoproteins and a decrease in sputum viscosity. Remains active with purulent sputum.

Increases the secretion of less viscous sialomucins by goblet cells, reduces the adhesion of bacteria on the epithelial cells of the bronchial mucosa. Stimulates the mucous cells of the bronchi, the secretion of which lyses fibrin. Similar action has on the secret formed in inflammatory diseases of the upper respiratory tract. It has an antioxidant effect due to the presence of an SH-group capable of neutralizing electrophilic oxidative toxins. Acetylcysteine ​​easily penetrates into the cell, deacetylated to L-cysteine, from which intracellular glutathione is synthesized. Glutathione is a highly reactive tripeptide, a powerful antioxidant, cytoprotector, trapping endogenous and exogenous free radicals and toxins. Acetylcysteine ​​prevents depletion and increases the synthesis of intracellular glutathione, which is involved in the redox processes of cells, thus promoting detoxification harmful substances... This explains the action of acetylcysteine ​​as an antidote for paracetamol poisoning.

Protects alpha1-antitrypsin (elastase inhibitor) from the inactivating effect of HOCl, an oxidant produced by myeloperoxidase of active phagocytes. It also has an anti-inflammatory effect (by suppressing the formation of free radicals and active oxygen-containing substances responsible for the development of inflammation in the lung tissue).

Indications for use

Acute and chronic respiratory disorders, characterized by increased secretion of thick mucus that is difficult to separate.

Paracetamol overdose

Method of administration and dosage

Inhalation

Adults: 300 mg (3 ml) 1-2 times a day for 5-10 days.

Children: up to 300 mg (3 ml) 1-2 times a day for 5-10 days. In the case of a strong secretolytic action, the secret is aspirated, and the frequency of inhalations and daily dose reduce. The frequency of use and the relative dosage can be changed by the doctor within acceptable limits, depending on clinical manifestation and therapeutic effect, without the need to differentiate the dosage for adults and children.

Endobronchial instillation.

Adults and children: 300 mg (3 ml) 1-2 times / day or as needed, in accordance with the chosen method of administration (indwelling catheter, bronchoscope, etc.).

Intranasal or endoauricular instillation.

Adults and children: 2-3 drops two or three times a day.

Parenteral

The duration of treatment should be determined based on clinical analysis. Good general and local tolerance of the drug allows long-term treatment.

The introduction of Fluimucil is also possible by slow intravenous (IV) administration in a hospital setting.

Adults 300 mg (3 ml) 1-2 times a day. Children from 6 to 14 years old- 150 mg (1.5 ml) 1-2 times a day.
Children under 6 years of age oral administration of the drug is preferred. For intravenous administration, Fluimucil solution is additionally diluted with 0.9% sodium chloride solution or 5% dextrose solution.

The duration of therapy is determined individually (no more than 10 days). In patients over 65 years of age - use the minimum effective dose.

Intravenous administration (as an antidote for paracetamol overdose)

Therapy must be started within the first 8 hours from the moment of taking paracetamol, further therapy is ineffective. When acetylcysteine ​​is used within 15 hours after an overdose of paracetamol, therapy is the least effective, however, there is literature that treatment can be effective within 16-24 hours after taking paracetamol.

The drug is administered by intravenous drip. Infusion should be carried out slowly to reduce the risk of side effects.

For patients weighing more than 40 kg, the following treatment regimen is used:

First dose: 150 mg / kg in 200 ml of solution after 60 minutes.

Second dose: 50 mg / kg in 500 ml of solution after 4 hours.

Third dose: 100 mg / kg in 1000 ml of solution after 16 hours.

For patients weighing more than 20 kg, the following treatment regimen is used:

First dose: 150 mg / kg in 100 ml of solution after 60 minutes.

Second dose: 50 mg / kg in 250 ml solution after 4 hours.

Third dose: 100 mg / kg in 500 ml of solution after 16 hours.

For patients weighing less than 20 kg, the following treatment regimen is used:

First dose: 150 mg / kg in 3 ml / kg solution after 60 minutes.

Second dose: 50 mg / kg in 7 ml / kg solution after 4 hours.

Third dose: 100 mg / kg in 14 ml / kg solution after 16 hours.

The solution is compatible with 5% dextrose solution, 0.45% sodium chloride solution or water for injection.

Side effects

When applied topically:

Reflex cough, bronchospasm, respiratory tract irritation, rhinorrhea

Stomatitis, nausea, vomiting

Hives, skin rash, itching

For parenteral administration:

Anaphylactic shock, anaphylactic and anaphylactoid reactions, hypersensitivity

Tachycardia

Bronchospasm, breathing disorder

Nausea, vomiting

Angioedema, urticaria, fever, skin rash, pruritus

Swelling of the face

Decrease blood pressure, prolongation of prothrombin time

Burning sensation at the injection site; with long-term treatment - impaired liver and / or kidney function

In very rare cases, severe skin reactions may develop, such as Stevens-Johnson syndrome, Lyell's syndrome. If such adverse reactions develop, the drug should be discontinued immediately.

When taking acetylcysteine, cases of a decrease in platelet aggregation have been described.

Contraindications

Hypersensitivity to acetylcysteine ​​and auxiliary components of the drug

Peptic ulcer and duodenum in the stage of exacerbation

Pregnancy and lactation

Hemoptysis, pulmonary hemorrhage

Carefully: peptic ulcer stomach and duodenum in remission, varicose veins veins of the esophagus, bronchial asthma (with intravenous administration, the risk of developing bronchospasm), adrenal diseases, hepatic and / or renal failure, arterial hypertension, children under 6 years of age.

Drug interactions

Fluimucil can be used together with general bronchodilators, vasoconstrictors, etc.

The combined use of acetylcysteine ​​with antitussives can increase sputum congestion due to suppression of the cough reflex.

With simultaneous use with antibiotics such as tetracyclines (excluding doxycycline), ampicillin, amphotericin B, their interaction with the thiol group of acetylcysteine ​​is possible, which leads to a decrease in the activity of both drugs. Therefore, the interval between taking these drugs should be at least 2 hours.

The simultaneous intake of acetylcysteine ​​and nitroglycerin can lead to an increase vasodilating action the latter.

Acetylcysteine ​​eliminates the toxic effects of paracetamol.

special instructions

Caution should be exercised when using the drug as an antidote in patients weighing less than 40 kg, since there is a possible risk of developing fluid retention in the body, followed by hyponatremia, convulsions and death.

Reception of acetylcysteine, in particular, in the form of an inhaled aerosol, can lead to dilution and, at the same time, an increase in the volume of bronchial secretions at the beginning of treatment. If patients are unable to cough up properly, the airway must be emptied using postural drainage or by suctioning fluid from the bronchi to avoid stagnation of secretions.

Patients suffering bronchial asthma should be under strict supervision during the period of treatment: if an attack of bronchial spasm occurs, treatment should be stopped immediately.