Medication

Inhaled Amikacin

Why is this medication prescribed?

Amikacin may be used to treat certain types of bacterial infections in the lungs (eg. Mycobacterium abscessus). It is sometimes used to reduce the amount of bacteria in the lungs (eg. Pseudomonas aeruginosa).

How does this medication work?

Amikacin belongs to a group of antibiotics called aminoglycosides. When it is inhaled, it reduces the amount of bacteria in the lungs. You may or may not feel better while taking this medication.

How is this medication taken?

The usual dose for amikacin is 500 mg twice daily via nebulizer. Take the medication as close to 12 hours apart as possible. Rinse your mouth after taking your amikacin.

Do not mix amikacin with other medications. Please refer to “Preparing your amikacin” for further instructions.

What are possible side effects?

Talk to your doctor if you experience side effects that are bothersome or do not improve with time. Some of the more common side effects include:

  • Wheezing
  • Cough
  • Sore throat
  • Voice hoarseness

Oral thrush is a possible side effect that may be prevented by rinsing your mouth after each dose. Your doctor may prescribe antifungal medication to treat oral thrush.

Talk to your doctor immediately if you notice any hearing loss, ringing in the ears, or problems with balance. These side effects are rare but potentially irreversible.

What do I do if a dose is missed?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (ie. less than 6 hours), skip the missed dose and go back to your regular schedule.

Regular use of inhaled antibiotics as prescribed is important to kill the bacteria and prevent resistance.

Inhaled Aztreonam (Cayston®)

Why is this medication prescribed?

Aztreonam is used to reduce the amount of bacteria in the lungs (eg. Pseudomonas aeruginosa). It is usually prescribed if you do not respond to other inhaled antibiotics such as tobramycin or colistin. It may also be prescribed if you have bothersome or severe side effects to other inhaled antibiotics.

How does this medication work?

Aztreonam belongs to a group of antibiotics called monobactams. You may or may not feel better while taking this medication.

In people with cystic fibrosis, aztreonam has been shown to improve lung function and reduce the chance of getting sick and needing oral or intravenous antibiotics.

How is this medication taken?

The usual dose for aztreonam is 75 mg three times a day via nebulizer. Take the medication as close to 8 hours apart as possible.

Do not mix aztreonam with other medications. Only use the nebulizer that is supplied with the medication. Please refer to the package insert that comes with your prescription.

What are possible side effects?

Talk to your doctor if you experience side effects that are bothersome or do not improve with time. Some of the more common side effects include:

  • Wheezing
  • Cough
  • Chest discomfort
  • Sore throat
  • Nasal congestion
  • Headache
  • Fever

Uncommon side effects include difficulty breathing, shortness of breath or joint swelling.

Talk to your doctor immediately if you notice any rash, hives or shortness of breath. Allergic reaction is uncommon but potentially serious.

What do I do if a dose is missed?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (ie. less than 4 hours), skip the missed dose and go back to your regular schedule.

Regular use of inhaled antibiotics as prescribed is important to kill the bacteria and prevent resistance.

Inhaled Ceftazidime

Why is this medication prescribed?

Ceftazidime may be used to reduce the amount of bacteria in the lungs (eg. Burkholderia cepacia, “cepacia”). If this is the first time you grow cepacia, ceftazidime may be prescribed for a short course (usually 3 months) to try to eradicate or get rid of the cepacia.

How does this medication work?

Ceftazidime belongs to a group of antibiotics called cephalosporins. When it is inhaled, it reduces the amount of bacteria in the lungs. You may or may not feel better while taking this medication.

How is this medication taken?

The usual dose for ceftazidime is 1000 mg (1 gram) twice daily via nebulizer. Take the medication as close to 12 hours apart as possible.

Do not mix ceftazidime with other medications. Please refer to “Preparing your ceftazidime” for further instructions. Foaming in the nebulizer may occur.

What are possible side effects?

Talk to your doctor if you experience side effects that are bothersome or do not improve with time. Some of the more common side effects include:

  • Wheezing
  • Cough
  • Sore throat
  • Voice hoarseness
  • Bad taste or smell

If you experience wheezing or coughing, take a bronchodilator (eg. salbutamol, Ventolin®) before each dose of ceftazidime.

Talk to your doctor immediately if you notice any rash, hives or shortness of breath. Allergic reaction is uncommon but potentially serious.

What do I do if a dose is missed?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (ie. less than 6 hours), skip the missed dose and go back to your regular schedule.

Regular use of inhaled antibiotics as prescribed is important to kill the bacteria and prevent resistance.

Inhaled Colistin (Colistimethate, Colymycin) 

Why is this medication prescribed?

Colistin is used to reduce the amount of bacteria in the lungs (eg. Pseudomonas aeruginosa). If this is the first time you grow Pseudomonas, colistin may be prescribed for a short course (usually 2 months) to try to eradicate or get rid of the Pseudomonas. Otherwise, colistin is used regularly to reduce the amount of Pseudomonas in the lungs.

How does this medication work?

Colistin belongs to a group of antibiotics called polymyxins. When it is inhaled, it reduces the amount of bacteria in the lungs. You may or may not feel better while taking this medication.

How is this medication taken?

The usual dose for colistin is 150 mg twice daily via nebulizer. Take the medication as close to 12 hours apart as possible.

Do not mix colistin with other medications. Please refer to “Preparing your colistin” for further instructions. Foaming in the nebulizer may occur.

What are possible side effects?

Talk to your doctor if you experience side effects that are bothersome or do not improve with time. Some of the more common side effects include:

  • Wheezing
  • Cough
  • Sore throat
  • Voice hoarseness

If you experience wheezing or coughing, take a bronchodilator (eg. salbutamol, Ventolin®) before each dose of colistin.

What do I do if a dose is missed?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (ie. less than 6 hours), skip the missed dose and go back to your regular schedule.

Regular use of inhaled antibiotics as prescribed is important to kill the bacteria and prevent resistance.

Inhaled Tobramycin (Tobramycin sulfate, TOBI®, TOBI Podhaler®)

Why is this medication prescribed?

Tobramycin is used to reduce the amount of bacteria in the lungs (eg. Pseudomonas aeruginosa). If this is the first time you grow Pseudomonas, tobramycin may be prescribed for a short course (usually 1 to 2 months) to try to eradicate or get rid of the Pseudomonas. Otherwise, tobramycin is used regularly to reduce the amount of Pseudomonas in the lungs.

How does this medication work?

Tobramycin belongs to a group of antibiotics called aminoglycosides. When it is inhaled, it reduces the amount of bacteria in the lungs. You may or may not feel better while taking this medication.

In people with cystic fibrosis, tobramycin has been shown to improve lung function and reduce the chance of getting sick and needing oral or intravenous antibiotics.

How is this medication taken?

The usual dose for tobramycin is different depending on which product you use:

  • Tobramycin sulfate: 80 mg twice daily via nebulizer
  • TOBI®: 300 mg twice daily via nebulizer
  • TOBI Podhaler®: 112 mg (4 capsules) inhaled twice daily

Take the medication as close to 12 hours apart as possible. If you are using the nebulized form of tobramycin, do not mix it with other medications.

For tobramcyin sulfate, please refer to “Preparing your tobramycin” for further instructions. For TOBI® and TOBI Podhaler®, please refer to the package insert that comes with your prescription.

What are possible side effects?

Talk to your doctor if you experience side effects that are bothersome or do not improve with time. Some of the more common side effects include:

  • Wheezing
  • Cough
  • Sore throat
  • Voice hoarseness

TOBI Podhaler® is more likely to cause coughing than other forms of inhaled tobramycin. Cough may occur in up to 30% of people but this often improves with continued treatment. TOBI Podhaler® may also cause change in taste.

If you experience wheezing or coughing, take a bronchodilator (eg. salbutamol, Ventolin®) before each dose of inhaled tobramycin.

Talk to your doctor immediately if you notice any hearing loss, ringing in the ears, or problems with balance. These side effects are rare but potentially irreversible.

What do I do if a dose is missed?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose (ie. less than 6 hours), skip the missed dose and go back to your regular schedule.

Regular use of inhaled antibiotics as prescribed is important to kill the bacteria and prevent resistance.

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