Tobi and Vest

[anonymous]

Hi, i think some of you have mentioned before that you cant or shouldnt do Tobi while doing the vest...is this true or am i dreaming? If so, is there any pattern to it that i should follow. I have to do a month of Tobi right now....twice a day every day. Its been about 5 years since i did it, and that was before i had the vest.

thanks

caitlin

 

[miesl]

The order I've heard is...

1. Vest and associated nebs (items to open the airway - albuterol, atrovent. mucus "stuff" - mucomyst, pulmozyme, saline), along with productive coughing.

2. Antibiotics.

I'm winging it on the explanation, but it makes sense to do it this way. Open the airways beforehand for higher lung penetration, and cough stuff up for increased distribution within the lungs and decreased bacteria medium and count.

 

[JazzysMom]

I dont even do my albeuterol with the vest on. It feels like I dont get the most out of any aerosol if my vest is on. Even if I am not vibrating it. So I do it before putting my vest on. It adds time to the treatment, but I feel its a more productive treatment. The meds I use & the order they go in are: Albeuterol, Pulmozyne, Vest, Pulmicort & Tobi. I was told to make sure Tobi is the last med to use.

 

[anonymous]

I don't use Tobi, but I use Amikacin as my second neb. I was told that you shouldn't do the vest during or after antibotic nebs as you want the medicine to stay in your lungs to do their job. If you do the vest with the antibotic, you could cough the medicine back out with your sputum. Hope that makes sense.

Barb 33 w/cf

 

[spicyone18]

I've always done xponex, pulmo, then tobi then vest. But while i was in the hospital they asked me if i liked doing the vest while nebbing, which i normally dont, but since they asked I guess that means that its ok to do the vest while doing tobi.

 

[anonymous]

Melissa
I do Pulmicort & Xopenex mixed in the neb. Have you or anyone else heard that this is not good? I noticed that you did them seperately and thought there may be a reason why.
Elle

 

[JazzysMom]

<blockquote>Quote<br><hr><i>Originally posted by: <b>Anonymous</b></i><br>Melissa

I do Pulmicort & Xopenex mixed in the neb. Have you or anyone else heard that this is not good? I noticed that you did them seperately and thought there may be a reason why.

Elle<hr></blockquote>

I have never mixed any meds in the neb. I assumed you shouldnt so didnt. My doctor never told me one way or the other. She did tell me that the pulmicort could be used in the same setuup as the albueterol, but not to actually mix any of the meds.

 

[anonymous]

We were taught by the resp. therapist to do alb and pulmicort mixed in the same neb cup. Then pulmozyme in its own neb cup. These can both be done while on the vest. Once done with vest, any chest pt and coughing, then do antibiotic. As the other posters have mentioned, the idea being open the airways, loosen the junk, get out what you can and then let the antibiotics settle in and do their work. When in the hospital this is also how they do it. Hope this helps. Jo Ann

 

[Diane]

I was told not to do Tobi ( or any other inhaled medication) while doing the vest. The main reason is.... while doing the vest you dont inhale as deeply as you normally would ,because the vest is a bit restrictive. Made a lot of sense to me. I do my morning routine in this order.

1-vest
2-advair
3-pulmozyme
4-tobi