Acetilcisteina: dove si trova e come usarlo

Introduction

What is acetylcysteine?

L'acetylcysteine (English: acetylcysteine) o N-acetylcysteine (NAC) is a pharmacological active ingredient patented in 1960, but only entered medical use eight years later.

Derivata dall’aminoacido L-Cisteina, grazie alle sue notevoli property is functions therapeutic, the NAC is an over-the-counter generic drug among the most widespread and used. It is therefore included in the list of essential medicines of theWorld Health Organization (WHO).

Today it is available in solutions spray inhalable, solutions eyepieces, powders, tablets to take by mouth and formulas injectable.

In the USA, in its tablet variant, this active ingredient is marketed as supplement food for the well-being of the organism.

Recently, also in Italy theacetylcysteine is available as a dietary supplement.

Where can we find acetylcysteine?

L'acetylcysteine is found in most più noti prodotti concepiti per la cura del naso che cola (rinorrea), della tosse grassa e di tutte le condizioni caratterizzate dalla presenza di muco o catarro in eccesso ( un esempio su tutti è rappresentato da Fluimucil Mucolitico).

Come spesso accade, molti utenti scelgono di acquistare i brand più conosciuti, ma in verità esistono prodotti altrettanto efficaci e disponibili a prices definitely lower.

Proprietà e funzioni

Mucolytic properties

There NAC è principalmente nota per le sue proprietà fluidificanti. L’acetylcysteine agisce infatti come un mucolytic, dissolving the mucus and the catarrh tipico delle infezioni delle vie aeree superiori e inferiori, decreasing the thickness and facilitating itsexpulsion, grazie a tosse e starnuti.

(Per approfondire l’azione mucolitica della NAC, rimandiamo all’dedicated article).

Other uses of acetylcysteine for the respiratory system

L’acetilcisteina ricopre anche altre importanti funzioni per l’apparato respiratorio. Ad esempio, essa viene anche utilizzata nell’immediato postoperative of the tracheostomy.

Viene impiegata nel trattamento delle chronic obstructive pulmonary disease (COPD), as an adjuvant treatment.

Instead, it is considered ineffective in the treatment of cystic fibrosis, as a review shows Cochrane of 2013.

Detoxifying properties for the liver

Spesso impiegata per combattere il sovradosaggio da paracetamol, L'acetylcysteine risponde increasing the level of glutathione, a antioxidant which can neutralize the toxic degradation products of the drug in question.

For this reason, in the USA it is used as dietary supplement antioxidant and for liver detoxification.

Acetylcysteine against paracetamol overdose

Ribadiamo che l’acetylcysteine, nelle sue formulazioni endovenose e orali, è impiegata nel trattamento del overdose of paracetamol.

When taken in large quantities, acetaminophen releases a metabolite called N-acetyl-p-benzoquinoneimin (NAPQI), che tende ad accumularsi.

Normally this is in conjugated form to glutathione (GSH) antioxidant but, if taken in excess, the reserves of GSH are insufficient for its deactivation.

The toxic effect occurs due to the reaction of NAPQI with key liver enzymes, thereby damaging the liver cells.

This can lead to severe liver damage and, in extreme cases, even death from liver failure acute.

Nel trattamento del sovradosaggio da acetaminofene (paracetamolo), agisce per to maintain or replenish the reserves liver depleted of glutathione, improving the non-toxic metabolism of paracetamol.

This is intended to protect liver cells from NAPQI toxicity. If administered within 8-10 hours after the overdose, theacetylcysteine it is more effective in preventing or reducing liver damage.

Research suggests that when theacetylcysteine is administered within 10 hours of the overdose, the liver toxicity rate is only 3% [Green JL, Heard KJ, Reynolds KM, Albert D (May 2013). "Oral and Intravenous Acetylcysteine for Treatment of Acetaminophen Toxicity: A Systematic Review and Meta-analysis". The Western Journal of Emergency Medicine. 14 (3): 218-26.].

Other applications

Acetylcysteine for kidneys and bladder

There is conflicting evidence on the possible benefits ofacetylcysteine in prevention of radiocontrast-induced kidney disease.

It has been used for hemorrhagic cystitis induced by cyclophosphamide (chemotherapy drug), although mercaptoethanesulfonate (mesna) is preferred - as it tends to decrease the effectiveness of cyclophosphamide.

NAC in psychiatry

L'acetylcysteine è stata studiata per il trattamento di numerosi disturbi psichiatrici, neurologici ed altre condizioni psicologiche come:

• morbo di Alzheimer;
• autismo;
• disturbo bipolare;
• neuropatia indotta da farmaci;
• disturbo depressivo maggiore;
• disturbo ossessivo-compulsivo;
• schizofrenia;
• dipendenze da farmaci specifici (cocaina);
• tricotillomania;
• disturbo da escoriazione;
• una certa forma di epilessia (mioclonica progressiva).

Certain preliminary evidence has shown efficacy in anxiety disorder, disorder from deficit of attention is hyperactivity e nel caso di un lieve head trauma, sebbene siano necessari ulteriori studi di conferma.

Evidence in abuse treatment Cannabis indica instead, they are few.

L'acetylcysteine it is not effective for the treatment of gambling, methamphetamine or nicotine addictions.

Quando e come si usa

When is it used?

L'acetylcysteine can be very useful in fight ai symptoms and ai clinical signs delle affezioni bronco-polmonari e delle vie aeree superiori:

• tosse con produzione di catarro;
• starnuti;
• mal di gola;
• naso che cola;
• dispnea;
• senso di malessere al petto, nei casi meno gravi;
• vero e proprio dolore al petto, nei casi più severi.

In particular, it manifests a marked action mucolytic, dissolving the mucus and phlegm (bronchi, nose, facial sinuses) and therefore facilitating their expulsion.

The use of NAC to counteract the effects of paracetamol overdose is to be considered exclusively sotto prescrizione e monitoraggio medico.

Some even use it as antioxidant food supplement, but this is mainly the case in the United States.

Avvertenze, effetti collaterali e tossicità

Acetylcysteine Warnings

L'acetylcysteine seems to be safety in pregnancy.

It is recommended to keep it out of the reach of children.

Se assunta quattro ore dopo l’assunzione di alcol etilico, gets worse liver damage in a dose-dependent manner. Before, however, it tends to decrease it.

Frequent side effects

The most common side effects ofacetylcysteine include:

• when taken orally, nausea is He retched;
• in any form, redness, rash is itch;
• rarely, non-immune anaphylaxis.

Others are: stomatitis, fever, rhinorrhea, drowsiness, sweating, chest tightness and bronchoconstriction. Although rare, bronchospasm has been reported to occur unpredictably.

Adverse reactions of high-dose acetylcysteine against paracetamol intoxication

Although theacetylcysteine both intravenously and orally equally effective for this therapeutic indication, due to the higher dosage required - designed to overcome its low bioavailability - oral administration is usually poorly tolerated due to bad taste and odor, which increase the incidence of adverse effects such as nausea and He retched.

However, it should be noted that the 3% to 6% of the people to whom theacetylcysteine intravenously shows a severe allergic reaction, similar to anaphylaxis, resulting in difficulty in breathing (due to bronchospasm), decreased blood pressure, rash, angioedema and sometimes even nausea and vomiting.

In these subjects, repeated doses of acetylcysteine intravenously will cause a progressive worsening of these allergic reactions.