EPOC - Bronchectasie

My wife is on the medication listed below:-

1.Carbocisteine 375mg capsules-  (2- three times a day).

2. Colistimethate 2million unit powder for solution delivered nebuliser (Twice a day)

3. Tiotropium bromide 18microgram inhalation powder capsules [Link to patient.info] (one am )

4. Budesonide 400micrograms/dose / Formoterol – (1 puff twice a day)

5. She is instructed in a technique called “huffing” by physiotherapists to help rid of phlegm.

Is there a right order to the use / inhale before or after huffing?

While I am unfamiliar with your wife's medication, my own experience suggests that medication is greatly challenged trying to work through a layer of mucous. Whatever effect it should have is dissipated by superfluous mucous. I know that when I have a headcold I need to up my meds because there is too much mucous around. This all suggests that clearing the chest first is the only way to go 

Hi

the rule that appears to be generally in place is to use bronchodilators first, then anything that loosens the phlegm, them chest clearing.

Once all that is done, then you have a better chance of the antibiotic getting to the right place in the lungs. Otherwise, the phlegm will block the antibiotics, and most of it will be brought out as you do your clearing.

so in your case, colistimethate will come at the end of the routine after the budesonide, tipotropotium and huffing .

Hope that helps.

best wishes

Sparkright is correct. The drugs that dilate airways first, then the clearing then any that act as an anti inflammatory last so they have a clear territory to work on

My ENT Doctor has me use Acetylcysteine in my Nebuleizer   it breaks up the phlem very fast...once I get it up I feel better...and it is cheap....Google it in...