N-acetylcysteine (NAC)

N-acetylcysteine is a sulphydryl compound that is used in the treatment of paracetamol poisoning.

• assists in the conjugation of toxic metabolites of paracetamol and so helps to prevent hepatic necrosis.
• it may produce an anaphylactic reaction
• mainstay of therapy for acetaminophen toxicity (paracetamol poisoning)

The primary role of N-acetylcysteine is associated with its antioxidant and anti-inflammatory activity, which favours the maintenance of a cellular redox imbalance (1)

• for this reason, its therapeutic potential concerns a series of diseases that link oxidative stress to its etiology and progression

N-acetylcysteine is also used as a mucolytic compound.

• approved for use in conditions with abnormal, viscid or inspissated mucous secretions such as (2)
  • pneumonia
  • bronchitis
  • tracheobronchitis
  • cystic fibrosis
  • tracheostomy patients
  • postoperative pulmonary complications
  • posttraumatic chest conditions
  • before diagnostic bronchoscopy to help with mucous plugging

Reference:

• Tenório MCDS, Graciliano NG, Moura FA, Oliveira ACM, Goulart MOF. N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants (Basel). 2021 Jun 16;10(6):967. doi: 10.3390/antiox10060967.
• Ershad M, Naji A, Vearrier D. N-Acetylcysteine. In: StatPearls. StatPearls Publishing, Treasure Island (FL); 2023. PMID: 30725868.