Acetylcysteine makes mucus less viscous in vitro by reducing the disulphide bonds in mucoprotein.1 Airbron (BDH) is a neutral 20% solution of acetylcysteine. The manufacturers claim that it makes expectoration of sticky sputum easier in bronchial disease and that it is therefore helpful in the pulmonary complications of cystic fibrosis, tracheostomy and surgery. It is administered by aerosol inhalation or by intratracheal instillation. Acetylcysteine seems to be rapidly inactivated by high concentrations of oxygen and itself probably antagonises some penicillins and tetracyclines in sputum.2 The makers now recommend that compressed air, and not oxygen, should be used for nebulisation.
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