Questions about giving nebs/cpt

TommysMommy · #1 01-10-2008, 02:06 PM

I'm still kind of new to Tommy's asthma/RAD diagnosis and I have a few questions. First of all, if Tommy is wheezing in his upper airway, but otherwise looks great will CPT do any good? I'm giving him Xopenex nebs every 6 hours right now, but even 15-20 minutes after a neb, I can still hear wheezing.

Secondly, can I give a pulmocort neb and a xopenex neb at the same time? As in mix them in the chamber and neb all at once. I've been giving them separately, but if he's getting them back to back at bedtime, I was hoping to save a little time. He hates to have to hold still for the nebs in the first place and giving two is a lot for him to have to deal with.

Third, is there anything that I can be doing for him for the wheezing besides steriods? He's not sick, just having a hard time with his lungs being inflamed.

TIA!

alizesmom · #2 01-10-2008, 02:26 PM

I was told never to mix things with the pulmicort. Hope you get on top of the wheezing. Karen

cariaad · #3 01-10-2008, 02:32 PM

Our doc says its ok to mix them, but I havent seen that it saves any time. Deb

aclancey · #4 01-10-2008, 02:53 PM

Our pulminologist told us not to combine the 2 meds. He said to give Xopenex first and then pulmicort because it absorbs better?!
I have noticed wheezing after a neb. I looked it up and found out it tis a side effect. He subsides after a little bit

suzanne2545 · #5 01-10-2008, 03:49 PM

Our hospital mixes them. But it is true that they pulmicort would be more effective if the xoponex is given first. We find it does save time as we are nebulizing less total liquid. Parker is good about sitting still for his nebs so often he will sit and read a book so I can get something else done. Not sure to what I owe this little smidge of cooperation from him but I will take it.

I don't think CPT would do anything for asthma. Asthma is restriction and the CPT is for congestion in the lungs. Different beasts. But in our case, the asthma flare ups can lead to a viral pneumonia where there is a lot of congestion.

JWorthington · #6 01-10-2008, 03:52 PM

We don't mix them, and we also give the pulmicort second, as it takes effect better that way. I don't think the CPT would help unless the lungs were congested - that's the only time I do it.

Julie

TommysMommy · #7 01-10-2008, 04:07 PM

Got it! Thanks everyone! No one ever told me to give the xopenex first. I'm going to start doing that tonight. I didn't think the CPT would do anything, but I wanted to be sure. I knew you guys would set me straight!

jenell3@insightbb.com · #8 01-10-2008, 05:34 PM

I was told by one of our older nurses that long ago they used to be instructed to mix them, now if you ask a respiratory therapists they say NO WAY do them separatley, GOOD LUCK!

alizesmom · #9 01-10-2008, 07:59 PM

Quote:

Originally Posted by TommysMommy

Got it! Thanks everyone! No one ever told me to give the xopenex first. I'm going to start doing that tonight. I didn't think the CPT would do anything, but I wanted to be sure. I knew you guys would set me straight!

New to me too. I always learn something here. Karen

cariaad · #10 01-11-2008, 08:45 AM

I think the idea is to have the xopenex open up the bronchi aand then the pulmicort can penetrate better. I guess...

I was wondering how it would be less liquid (suzanne)? Do you add saline? We never have been told to. Deb