Table 1.
Reference | Population | NAC Formulation, % | Goal of NAC Therapy | Outcome | Adverse Effects |
---|---|---|---|---|---|
Burke6 | In vivo: mice | 4 | To quantitate the dry weight of stool and measure toxicity | 4% NAC resulted in less stool output than controls | Minor intestinal mucosal changes |
In vivo: meconium from term, healthy, human newborns | To assess the ability of the test solution to break down meconium | 69% decrease in meconium viscosity immediately, over 99% viscosity reduction at 6 hours | N/A | ||
Parrish12 | 25-yr-old F with CF | 4 | To relieve intestinal obstruction | 120 mL evacuated | None reported |
4 | To prevent recurrence of intestinal obstruction | Discharged on postoperative day 15 without further GI complications | |||
Khaitov1 | 19-yr-old F with CF | Not reported | Resolution of ileus | Not successful for initial disimpaction | None reported |
Lillibridge13 | 26-yr-old M with CF | Not reported | Prevention of intestinal obstruction | Complete resolution of abdominal symptoms | None reported |
Treatment of intestinal obstruction followed by a weekly enema for obstruction prevention | Successfully treated | ||||
Mabogunje14 | 2 neonates with radiologically confirmed MI | Not reported | To relieve intestinal obstruction | Unsuccessful in both patients | None reported |
Garza-Cox15 | 8 premature (VLBW infants) | 20 | To relieve intestinal obstruction | Successful in 2/8 patients | None reported |
Shaw11 | 48 puppies 3 days to 3 mo | 2–20 | To assess the effects of varying concentrations and volumes of NAC on fluid volumes in the bowel, changes in hematocrit, and microscopic tissue analysis | Not assessed | 20% NAC caused extensive fluid shifts, hyperemia, and multiple hemorrhages; effects were more severe in younger puppies |
Bailey9 | 3-yr-old M with CF | 4 | To relieve intestinal obstruction | Progression to a diatrizoate meglumine and diatrizoate sodium enema for disimpaction | Liver biopsy confirmed drug-induced liver injury |
Cooke16 | Neonate born at 38-wk gestational age with CF | 0.2 | To relieve intestinal obstruction | Successful response | Dramatic increase in transaminases and bilirubin following NAC administration |
Langer8 | Premature infant, 30-wk gestational age with MI | 5 | To relieve intestinal obstruction | Successful response | Hypernatremia; returned to normal within 24 hours after discontinuation |
CF, cystic fibrosis; F, female; GI, gastrointestinal; M, male; MI, meconium ileus; N/A, not applicable; NAC, N-acetylcysteine; VLBW, very low birth weight