Asthma

Question
Posted by: Roland | 2017/06/12

Q.

When should duolin nebs be used by nebulizer for copd and what is it's purpose? Does it also help to clear phlegm from the chest?

I have been discharged from hospital after an exacerbation of my copd condition. I am still coughing up green phlegm although difficult to get out. The daily maintenance chronic medicine I am using is fox air 50/250, 200mg Theophylline (morning and evening) and Forvent inhaler, morning only. Further more, I have duolin respules to be used when required and lastly a Duovent inhaler for extreme shortness of breath. Thus the question as to when should my nebulizer be used and does it also to loosen phlegm on my chest? Thank you so much for this wonderful service.

Expert's Reply

A.

Asthma Expert
- 2017/06/19

If you are able to use your inhalers without a problem then the nebuliser does not generally add too much.  Thus, in the majority of cases using an inhaler will deliver as much bronchodilator to the airways as does a nebuliser.  There are rare instances where a nebuliser might be useful in dilating the airways and that is when enough drug cannot reach the airways using an inhaler.  This may be because of poor inhaler technique or because the lungs may be too weak to generate enough respiratory effort to get enough medication into the airways.  However, this is rare and unless you fall into this category, using the nebuliser will not add much.  It should also be remembered that the nebuliser may have certain side effects including making one jittery and also increasing the heart rate.  This may not be such a good thing if you have cardiovascular disease.  Thus, overall nebulisers should be used with caution and only when absolutely necessary.

 

One thing that might be useful to loosen phlegm is to use hypertonic saline for nebulisation.  However, be careful.  It must not be “normal” saline but hypertonic saline.  Your doctor can prescribe this for you and there are 50ml sachets that you can obtain from the pharmacy from which you can draw up saline for nebulisation.  Use this 2 or 3 times a day and it will help with loosening up the phlegm.



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