Does anyone nebulize Budesonide and Albuterol?

@pled Technically, it is OK to mix them - they are chemically compatible. One of my exacerbation meds is actually a mixture of albuterol and an inhaled corticosteroid.

However, the respiratory therapist told me it is more effective to nebulize the albuterol first to open airways, wait 5 minutes then do the budosenide. When using saline as well, my instructions are albuterol first, then saline, do airway clearance to get up mucus, then steroid last (so more stays in the lungs.) Fortunately, I only have to do that when I have an exacerbation.

My usual daily routine is: Symbicort inhaler, wait 5-10 minutes, 7% saline & airway clearance. After almost a year, I can confidently say this new regimen has kept me healthier than anything in the past 10 years.

According to my ID doc, the most important order is "however you can do it and still live your life." That is very important, because just like New Years' resolutions or diets, regimens that you cannot easily fit into your life are quickly abandoned.

Are you doing airway clearance? Using saline?
Sue

Thanks, Sue. You are always so helpful. I am one of those people who do not cough much of anything up. I have tried several times unsuccessfully to give a sputum sample. I also use an acapella after nebulizing, and a vibrating vest. Every now and then in the course of the day I may cough up a small chunk of mucous. I do not use saline.

I am also one who could not cough up enough for a sputum sample, until I started regular nebulizing with saline. I do 7% twice a day 10 minutes after albuterol inhaler. I've also switched from Acapella to Aerobika which I find more effective.
Anna

Thanks for your reply. There seem to be so many ways to skin this cat! I think I will talk to my pulmonologist about the saline on my next visit.

I think I need to re-check the way I'm nebulizing as I had understood from pulmonologist to use saline first -- then albuterol followed by Budesonide, Perforamist and Yupelri. It's not a program that seems to help but if I stopped, perhaps I would realize it did help some. Not having great luck with anything. Have been in Rochester Mayo's hospital a few months back -- came home with picc line and have done many infusions with different meds -- none of which worked. Sometimes it's quite depressing. I had breathing episodes with tobramycin and colistin and did 63 infusions of another one I can't even remember the name -- and that was not effective either. I have tons of green phlegm every day -- the coughing is continuous. Any ideas, anyone?????

I too have bunch of mucus to clear. Does anyone here know what it means to have Hypoxic respiratory failure

Welcome to Mayo Connect. Let's talk about your second question first. Hypoxic respiratory failure is a serious condition that is diagnosed when the lungs are so damaged that they cannot provide enough oxygen exchange circulating blood oxygen high enough to support life.
Have you been given this diagnosis? Are you using supplemental oxygen? What lung conditions do you have?

I have been diagnosed with the Hypoxic respiratory failure. I have COPD. Not sure what stage of COpD that puts me in. Is this considered end stage COPD? I have never smoked in my life

I can't answer those questions for you-only your doctors have the information to do that. Have you asked them these questions?

auntnanny... I'm sorry to hear the infusions haven't cleared up your mucus. Have you tried postural drainage? There are You tube videos that show the different positions. When my lungs were full of yellow mucus, it turned out to be Candida which does not respond to antibiotics. I used Candida Cleanse for 6 months and my bronchoscopy showed no more Candida. You may be unfortunate enough to have antibiotic resistant germs. I sincerely hope not. Try the postural drainage to clear out as much mucus as you can. I've started the new drug Brinsupri and after 3 weeks am still on maintenance azithromycin. It seems to work to keep the infection down.
Alternative s like cupping (through acupuncture) and N -ACL, beetroot, etc have sometimes been helpful when hope is waning. Don't be afraid to try something new.