Nebulization of N-Acetylcysteine Combined with a Bronchodilator in Patients with Chronic Bronchitis

A Controlled Study

¹ Cardiopulmonary Laboratory, Wood Veterans Administration Hospital and the Department of Medicine Marquette School of Medicine, Milwaukee, Wisconsin

In a controlled seven week study in ten patients with chronic obstructive bronchitis, nebulized N-acetylcysteine combined with racemic epinephrine was highly effective in thinning sputum. By contrast, nebulized saline plus racemic epinephrine tended to make the sputum thicker in these same patients. Neither the N-acetylcysteine-racemic epinephrine combination nor the salineracemic epinephrine aerosol exhibited any observable effect on the chest roentgenogram, spirometric measurements or sputum volume in this group of patients. The bronchial obstruction previously observed with N-acetylcysteine alone did not occur when the drug was nebulized with racemic epinephrine. We would conclude that whenever N-acetylcysteine is administered, a bronchodilator should be nebulized concomitantly unless there is a clear contraindication to its use.