Dosage of Acetylcysteine in Treatment of Renal Failure

Renal failure occurs once there is extensive damage to the kidneys caused by conditions such as diabetes and hypertension as well as drug intoxication. Proper dosage administration of acetylcysteine may help improve patient conditions under dialysis. It also helps reduce the risks of renal failure among patients susceptible to develop the condition after cardiac surgery. There are variable dosages and means of administration of acetylcysteine among these patients.

Indications

• Acetylcysteine, a thiol containing compound is indicated for respiratory conditions such as in the treatment of respiratory infections, acute and chronic bronchitis and its exacerbation, thick mucous production and chronic obstructive pulmonary disease (emphysema). It is also indicated for the management of renal failure where its post radiocontrast administration suppresses proximal tubular injury caused by stress mediated oxidant that can damage the kidney.

Benefits

• There are innumerable benefits from acetylcysteine. Its administration with the proper dosage can result to significant decrease in deaths due to cardiovascular accidents, prevent elevation of blood pressure and increases the blood flow to the kidneys thereby reducing the accumulation of unwanted waste products in the body that leads to uremic symptoms such as breathlessness, ankle swelling, vomiting and dizziness.

  When used with adequate hydration, this drug helps protect from radiographic contrast induced nephropathy in heart attack patients undergoing angioplasty. Its use has been considered as an additional supplement for protecting cells against aging and cancer. It also provides the body with high levels of anti-oxidant supplements and prevents acetaminophen toxicity that can damage the liver.

Dosage and Administration

• Acetylcysteine is available in variable dosage and administration. It is available in 4, 10 and 30 mL glass vials. 20 percent of its solution may be diluted with sterile water injection or inhalation forms and sodium chloride inhalation or injection. 10 percent of the drug solution may be administered undiluted.

  The drug may be given orally, intravenously and as an inhalant. It is recommended to administer a nebulizing dose of 3 to 5 mL from the 20 percent of the solution or 6 to 10 mL from the 10 percent solution given 3 to 4 times daily. The direct instillation of the drug may be done every hour at 1 to 2 mL from the 10 to 20 percent of the solution. Oral administration of the drug requires dilution of 20 percent solution with diet soft drinks until it reaches 5 percent final concentration.

Warning

• Large doses of acetylcysteine cause nausea when taken on an empty stomach. Other side effects include urticaria, bronchospasm, nasopharyngeal and gastrointestinal symptoms such as vomiting, diarrhea and abdominal pain. Doses should not exceed 500 mg when taken orally to avoid side effects.

  Care should also be taken in patients with known sensitivity to the component of the drug, newborns, asthmatic patients with history of peptic ulcer, pregnant and breastfeeding women.

  When taking this drug all diuretics, pain medications and Ace inhibitors should be withheld until the time of the procedure. Serious allergic reactions have been reported like rashes, swelling on the face, extremities, and tongue, severe itching, dizziness and difficulty of breathing.

Considerations

• Extra care must be taken with acetylcysteine solution to prevent contamination of its sterile solution since it does not contain antimicrobial agent. The drug must be prepared and utilized within an hour. The remaining undiluted solution must be stored in the refrigerator and must be used within 96 hours.