N-acetylcysteine (NAC) is the mainstay of therapy for acetaminophen toxicity. Summarize the importance of improving care coordination among the interprofessional team to enhance the delivery of care for patients who can benefit from therapy with NAC.Outline the administration of NAC in both APAP toxicity and in in lung conditions requiring mucolytic therapy.Describe the mechanism of action of NAC in both acetaminophen toxicity and in conditions where mucolytic activity is beneficial.This activity outlines the indications, mechanism of action, methods of administration, important adverse effects, contraindications, monitoring, and toxicity of NAC, so providers can direct patient therapy to optimal outcomes where NAC is indicated. Off-label indications include acute hepatic failure, prevention of contrast-induced nephropathy and topical treatment of keratoconjunctivitis sicca. It is also approved for use in conditions with abnormal, viscid or inspissated mucous secretions such as pneumonia, bronchitis, tracheobronchitis, cystic fibrosis, tracheostomy patients, postoperative pulmonary complications, posttraumatic chest conditions and before diagnostic bronchoscopy to help with mucous plugging. NAC has FDA approval for the treatment of potentially hepatotoxic doses of acetaminophen (APAP), and it is almost 100% effective if given within 8 hours post-ingestion.
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