• Perennial and seasonal allergic
rhinitis are hypersensitivity
reactions
to an allergen.
• Allergens which cause these symptoms include house dust mites, pollens and moulds.
• The symptoms are due to the effects of mast cell degranulation. The effects can cause serious
complications, such as otitis
media
and chronic
sinusitis.
• Treatment of allergic rhinitis includes antihistamines (as chlorpheniramine, loratadine,
cetrizine, and fexofenadine), H1 receptor antagonists (as axelastine) and corticosteroids (as beclometasone and budesonide).
• The first choice treatment for children is cromoglicate.
- Prepared by: Dr. Mohamed Abdel Rahman (pharmacist).
- Resources: - Clinical physiology and pharmacology,Farideh Javid and Janice McCurrie 2008.
- Copyrights: All rights are reserved for pharmacist development group 2009 - 2011.
• Symptoms of cystic fibrosis
include secreting of very viscous mucus in the lung and suffering from repeated lung infections.
The pancreas is also affected and patients are deficient in pancreatic
enzymes; this reduces digestion and absorption of nutrients, so affecting growth.
• Patients with cystic fibrosis need physical therapy and
postural drainage to clear the airways because the viscous mucus in cystic
fibrosis is difficult to clear from the lung.
• Sweat glands have sympathetic
cholinergic innervation. Patients with cystic fibrosis secrete a large amount of
salt in their sweat and this forms the basis of a diagnostic test for the
condition.
• Since cystic fibrosis patients lack
digestive enzymes, enzyme preparations containing amylase, lipase and
proteases are prescribed to patients in order to improve intestinal absorption of nutrients.
- Prepared by: Dr. Mohamed Abdel Rahman (pharmacist).
- Resources: - Clinical physiology and pharmacology,Farideh Javid and Janice McCurrie 2008.
- Copyrights: All rights are reserved for pharmacist development group 2009 - 2011.
•Lung volumes are changed
differently by restrictive and obstructive disease.
•The main causes of Obstructive lung disease are smoking or prolonged exposure to industrial smokes and
fumes. •The destruction of lung tissue in emphysema is permanent and
irreversible.
• A trial of corticosteroids and
bronchodilators is recommended because there may be an inflammatory
component in obstructive lung disease,
• Patients with obstructive lung
disease who smoke should quit smoking in order to reduce their
risk of heart disease and to decrease mortality.
- Prepared by: Dr. Mohamed Abdel Rahman (pharmacist).
- Resources: - Clinical physiology and pharmacology,Farideh Javid and Janice McCurrie 2008.
- Copyrights: All rights are reserved for pharmacist development group 2009 - 2011.
#Mucolytic
agent in Bronchial disorders, chronic bronchitis, asthma, emphysema, pulmonary
complications of surgery.
# Antidote for acetaminophen poisoning.
Mechanism of action
# As mucolytic agent: disrupts
disulfide bonds in mucoproteins thereby lowering viscosity of mucus.
#
As antidote for
acetaminophen poisoning: complexes with hepatotoxic free radial metabolite
of acetaminophen and inactivates it.
route / Dosage form
# Route
: Oral, inhalation,
IV.
# Dosage form : Soln: 10, 20%
Dose
# Bronchial disorders, chronic
bronchitis, asthma, emphysema, pulmonary complications of surgery :-
* Adults:
6–10 mL of 10% solution, q2–3 hours by nebulizer.
* Children:
3–5 mL of 10% solution, q2–3 hours by nebulizer.
* Infants:
2–4 mL of 10% solution, t.i.d. to q.i.d., IV.
* Alternate:
20% solution may be given in half of above volumes.
# Antidote for acetaminophen
poisoning
* Adults,
children: Initially 140 mg/kg, then 70 mg/kg q4h orally x 17 doses. All 17
doses must be given, even if acetaminophen
levels have declined to non-toxic range. If patient has emesis with 1
hour of dose, repeat dose immediately.
Pregnancy / Lactation
# Pregnancy: Category B.
#
Lactation: No data available. Best to avoid.
Adverse reactions
# Common: vomiting,
olfactory disturbance.
# Serious: bronchospasm (especially
in asthmatics), hypotension.
Important interactions
#
None
Contraindications / precautions
# As inhaled drug: may induce
bronchospasm. If this occurs, administer bronchodilator; suction bronchial
secretions if they develop after inhalation.
# Elderly: May have reduced cough
reflex and therefore reduced ability to clear airway of liquefied mucus. May
need concomitant suction.
# For patient with asthma or
hyperactive airway disease, a bronchodilator should be administered before
acetylcysteine.
Other notes
#
To be given before meals and just before
bedtime for asthma.
# As antidote
for acetaminophen poisoning: Administer as quickly
as possible. Most useful if given within 12 hours of ingestion of acetaminophen.
Practical notes
#Rinse mouth out and wash face
after treatment to remove adhering drug.
Generic names
#
Egypt :- Acetylcistein , ACC
, Mucomyst .
#
KSA :- ACC, Acetylcistein.
- Prepared by: Dr. Mohamed Abdel Rahman (pharmacist).
- Resources: - Handbook of clinical drug data. 10th edition. - Clinician's handbook of prescription drugs. - Master of Egyptian drugs. - physicians' Drug manual 2005 edition. - Master of Saudi drugs.
- Copyrights: All rights are reserved for pharmacist development group 2009 - 2011.
