Bronchiectasis what are the stages and symptoms

Posted by raney @raney, Oct 18, 2021

I was diagnosed with bronchiectasis about the time that Covid hit the US and the pulmonologist are overworked, so I have lots of unanswered questions. I also am taking Bisoprolol Fumarate 2.5 mg (a beta blocker) for heart issues. This is the 3rd cardiac med that has been prescribed in hopes of finding something that works with heart and does not interact with pulmonary meds.
Is there away to shorten the time of treatment?
1. Will I have to spend 3 hours 2 X a day for the rest of my life with nebulizer treatments, smart vest, gargles and nasal washes?
2. Is there anyway to shorten the time of nebulizer. (I have been prescribed (a) Levalbuterol which I can not use because it makes breathing more difficult (b) Sodium Chloride 7% (c) Budesonide all by nebulizer.
I use Aerobika and Smart Vest at intervals during nebulizer treatment.

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rits | @rits | Oct 21, 2021

In reply to @alleycatkate "@raney. I read your post about time spent doing airway clearance. Seems that you spend an..." + (show)

I get NOW brand Nac from Amazon. I just checked and it is available there along with some other brands.

rits | @rits | Oct 21, 2021

In reply to @rits "I get NOW brand Nac from Amazon. I just checked and it is available there along..." + (show)

Oops. Need to look more carefully. It's seems to be something that looks like nac but isn't.

rits | @rits | Oct 21, 2021

In reply to @rits "Oops. Need to look more carefully. It's seems to be something that looks like nac but..." + (show)

Gee whiz. I have been taking NOW brand Acetyl L - Carnitine not Cysteine . Duh! I have been taking NAC for so long that I never even looked at it and it's 500 mg not 600 which one would think would have made me look at it more carefully. The ironic thing is that the one I am taking is to help sharpen thinking. Haha

If anyone finds a place to order NAC please let me know.

Feeling pretty stupid and grateful for the discussion because I never would have noticed the difference.

alleycatkate | @alleycatkate | Oct 21, 2021

In reply to @rits "Gee whiz. I have been taking NOW brand Acetyl L - Carnitine not Cysteine . Duh!..." + (show)

@rits..haha..You are too funny (the irony)!! It seems like an easy mistake and I'm glad that you have caught the different product. NOW products all look the same!! I ordered my last order of NAC from VitaCost (their brand) since I can't find the NOW brand any longer.

rits | @rits | Oct 21, 2021

Tks. Vitacost is out of stock.

Sue, Volunteer Mentor | @sueinmn | Oct 21, 2021

In reply to @rits "Tks. Vitacost is out of stock." + (show)

Here is what I use now. Swanson supplements are well rated for containing the listed ingredients and strength.
https://www.swansonvitamins.com/swanson-premium-nac-n-acetyl-cysteine-600-mg-100-caps
I cannot tell a difference from the Jarrow I used before.
Sue

raney | @raney | Oct 21, 2021

In reply to @alleycatkate "@raney. I read your post about time spent doing airway clearance. Seems that you spend an..." + (show)

Thank you, Kate, This lung disease is all new to me and I have so much to learn. I do take Mucuinex 2 X day and use flutter device (Aeroika), Smart Vest, and nebulizer. I have not heard of NAC but I certainly will find out. Thank you for the link. One reason it takes me so long, (I think) is because there is SO MUCH thick mucus, and sometimes I use 2 ampules of 7% Saline to feel that I am half way "unclogged." I wish my doctors had listened to my complaints and diagnosed the problem before it got so bad. I didn't have a clue! I thought it was my heart and a bad respiratory infection for about the 1st two years and that was with a PCP only.

raney | @raney | Oct 21, 2021

In reply to @alleycatkate "@raney...sorry...here is the excerpt that I found most relevant to our situations with the lung: N-acetyl-cysteine..." + (show)

@alleycatkate

@raney...sorry...here is the excerpt that I found most relevant to our situations with the lung:

N-acetyl-cysteine (NAC) is included in the World Health Organization’s list of essential medicines; a list that details the most relevant medications needed for a basic health system [1]. Acetyl-cysteine is a derivative of cysteine in which an acetyl group is attached to nitrogen. Due to its disulfide reducing activity, NAC is used as a mucolytic agent to promote expectoration [2]. NAC is commonly prescribed as an adjunct therapy in patients with a wide range of respiratory diseases characterized by formation of thick mucus, such as cystic fibrosis [2–4]. At high doses, NAC results in significantly improved small airway function and decreased exacerbation frequency in patients with stable chronic obstructive pulmonary disease (COPD) [3, 4]. NAC’s mucolytic activity is also the basis of its use in liquefying sputum samples for the microscopic detection of acid-fast bacilli (AFB) in suspected pulmonary tuberculosis (TB) patients [5]. Furthermore, in both experimental animal models and clinical studies, NAC displays a protective effect on acute liver injury induced by anti-TB drugs in acetaminophen-dependent or independent conditions [6–11]. In patients with type 2 diabetes, NAC holds promise in primary prevention of cardiovascular complications and systemic inflammation [12–14].

In addition to the above clinical applications, NAC has been employed as a potent anti-oxidant in several experimental models of infection and cancer in vitro and in vivo [15–20]. In these settings, NAC serves as a pro-drug to L-cysteine, which is a precursor to the biologic antioxidant glutathione. This anti-oxidant property of NAC is associated with strong anti-inflammatory effects, which have been suggested to inhibit the activation of nuclear factor-κB (NF-κB) with subsequent inhibition of cytokine synthesis [2, 21, 22]. In a mammalian model of Mycobacterium tuberculosis infection, NAC has been shown to diminish TB-driven lung pathology and inflammatory status, as well as to reduce mycobacterial infection loads in the lung [23]. These effects were attributed to the drug’s anti-oxidant properties and immune regulatory activities. Whether NAC limits M. tuberculosis infection in this situation through a direct microbicidal effect on M. tuberculosis was not addressed. Indeed, NAC has been shown to exhibit anti-microbial activity against a number of bacterial pathogens including Pseudomonas aeruginosa, Staphylococcus aureus, Helicobacter pylori, Klebsiella pneumoniae and Enterobacter cloacae [17, 24–26].

In this study, we demonstrate that NAC directly impairs the growth of several species of mycobacteria in vitro independent of its inhibitory effects on the host NADPH oxidase system. This anti-mycobacterial effect was also observed in an experimental model in vivo. Thus, NAC may limit M. tuberculosis infection and disease both through suppression of the host oxidative response and through direct antimicrobial activity. This dual host and pathogen directed function makes the drug an interesting candidate for use as adjunct therapy for tuberculosis.

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Thank you for sharing that article. It sounds like a "wonder drug." I am going to ask my doctor at the Pulmonary Specialty clinic at UNC- Chapel Hill. Raney