- In what order should I take my inhaled meds?
“Bronchodilators first (e.g.salbutamol [Ventolin®]), to open up the airways.
Mucolytics second (hypertonic saline or dornase [pulmozyme®]), to loosen/thin secretions
Wait 30 minute (if possible)
Do airway clearance next.
Steroids (e.g budesonide [Pulmicort®] or Symbicort®)
Antibiotics (e.g. tobramycin, TOBI®, aztreonam [Cayston®], colistin [colymycin®])”
- Which nebulizer for which medication?
Salbutamol and hypertonic saline can be taken with any nebulizer you like, even one with a mask. Antibiotics should usually be nebulized with the Pari LC Plus. Pulmozyme should be taken with the Pari LC Star. Antibiotics and pulmozyme should be taken using a mouthpiece unless otherwise directed by your physician.
- Why do my nebs take so long?
Usually, this is related to the equipment you’re using. If you’re using the right nebulizer, and your compressor is running well, most meds shouldn’t take more than 15 minutes to run through, and some take much less than that. If things are taking much longer, it may be because your nebulizer needs to be replaced, or the compressor filter might be clogged, or there may be a problem with the compressor itself. If you are doubling up meds (like mixing hypertonic saline and ventolin), it may be that there is just too much volume in the nebulizer. Also, most meds don’t need to be run until the nebulizer is bone dry. Having a few drops leftover (up to 1 mL in the case of Tobi) is okay.
- Where can I get an eFlow?
This device is finally available in Canada! The eFlow Rapid, and replacement parts for it, can be purchased at www.agecomfort.com. Enter "eRapid" into the search field.
The eFlow Trio is available in the US, but medication doses need to be adjusted for this model, so if you decide to buy one, please inform the CF Clinic so your physician can advise you on the proper dosing of your meds. YOU SHOULD ALSO DO THIS IF YOU ARE CONSIDERING USING YOUR ALTERA NEBULIZER FOR MEDICATIONS OTHER THAN CAYSTON, WHICH IS NOT RECOMMENDED.