Pulmicort & Albuterol given together?

DS was just prescribed Pulmicort, in addition to Albuterol that he was prescribed when he was 5 months old (he had RSV then). DH thinks that the doctor said they can be mixed together, but the pharmacist I talked with said No, give the Albuterol, and then the Pulmicort. DS will sit still for a while, but not necessarily the whole treatment of Albuterol, and the thought of having to do it 4 times a day makes me cringe! We have watched Baby Mozart often enough that he knows when the dragon says "Blah!" and he would say it just before the dragon does! I don't know about watching TV 4 times a day....

I know some of you have had both Albuterol and Pulmicort, did you administer them together (+ Broncho Saline of course for the Albuterol) or did you do them separately?

Thanks!

Off the top of my head, I don't know the answer. I am a pharmacist, and DH is a physician - he's in bed but didn't know the answer either!
When I was working at the hospital, we would often get calls from people in the community about things and we had alot of resources to look things up. You could try calling a local hospital and asking for the inpatient pharmacy, or I would probably ask for the respiratory therapy department. They would know the answer since they deal with it daily.
If you have any problems getting an answer, let me know - I can make some calls. Did the pharmacist you talked to look it up somewhere? I always try to follow through because I think sometimes people get too busy and rather than spending the time to research, they just say no to be on the safe side. I know people that did this when a nurse would call about mixing IV meds. It was easier/quicker to say no, but of course then it made it harder for the nurse and patient!

Good luck!

DD is taking Pulmicort and Xopenex (an alternatvie to albuteral) and the directions on the Pulmicort say there are no studies on mixing them together (it says "Pulmicort Respules has not been studied when mixed with other nebulizable medications. PR should be given seperately in the nebulizer.". The information sheet the pharmacy gave us says something about the Xopenex being used first since it opens the airways allowing the Pulmicort to go deeper into the lungs. We're also having a hard time with all of the breathing treatments.

Good luck, I feel your pain!!

Lisa

Jan & Lisa,

Thank you so much for your input, I really appreciate it.

DS is much better today, so hopefully the Albuterol treatment can be weaned in a couple of days. The Pulmicort is for maintenance, and we have a prescription for 1 year!

I have been giving it separately today, and so we'll just keep giving it separately.

Thanks.

Chiming in late here, but my pharmacist told me to give the albuteral/xopenex first and then the pulmicort. My pediatrician and my pulmonologist have said to just mix them together. However, it doesn't really save time other than to take a break and add the second medication. The medications mixed together tke the same amount of time to nebulize as they do separately so you're only saving the step of setting up the machine, if that makes sense.

If your son doesn't like sitting through back to back treatments, then I would split them up at separate times during the day. Sometimes Abbie will sit through both (like at night when she's ready to fall asleep) and sometimes she won't (in the morning). There are times that I need to give 2 pulmicort treatments a day -- in the morning I would separate it out from an albuterol treatment by an hour or so -- and in the evening I would do them together; sometimes I mix and sometimes I don't depending on my mood. Even though the pharmacist (and the literature) were against it, my pulmonologist is a top rated doctor, and I figure I can follow her advice.

Hi Marci,

Thanks for writing.

Yes, you are right, it doesn't really save time. The only thing is that DS sometimes declares "dah" which means done when the mask is removed, so I try not to remove the mask until we are really all done :-)

Some days he doesn't mind the treatments, some days he screams and screams - even with video playing. O well... Now we are giving him Pulmicort only (twice a day) since his wheezing has stopped.