Inhaled Medications and Nebulizers
The Cystic Fibrosis Foundation and the Stanford CF Center staff recommend the following sequence for inhaled medications:
- Bronchodilators (Albuterol, Combivent, Xopenex) to open the airways
- Hypertonic Saline (7%) to mobilize mucus and improve airway clearance
- Pulmozyme (DNAse) to thin mucus
- *Airway Clearance Technique: Vest, Flutter, Chest PT, IPV, etc.
- Antibiotics (TOBI, Colistin, Cayston). The previous therapies open and clear the airways of mucus, allowing these antibiotics to work on remaining bacteria.
- Steroids (Flovent, Pulmicort, QVAR)
* When using the Vest for airway clearance, make sure there is aerosol delivery during the entire vest session.
If you start coughing blood, temporarily stop Pulmozine, saline, airway clearance technique, and inhaled antibiotics. Call your CF doctor or nurse for further advice.
With a respiratory illness or change in symptoms:
- Begin or increase airway clearance techniques.
- Use breathing treatments as ordered; you can use bronchodilators every three to four hours, and often additional Vest and/or hypertonic saline treatments are useful.
- Contact your CF doctor or nurse to see if antibiotics or additional intervention is needed.
