Albuterol, piratropium and pulmacort

hi, my question is can we mix albuterol, ipratropium, pulmacort together and the order is give these
medication together by nebulizer.

[caregiver222]

The answer is complicated. The reason for giving these medications sequentially, is that they have different effects. By giving one med before the other the optimal medicinal performance is obtained with a minimum of medication. There is a difference of opinion regarding this issue. My brain is foggy, but that is how it was explained to me a long time ago by a very knowledgable R.N.  Ocassionally there are side effects, and mixing the drugs does not hold well for figuring out the problem.

[Kestra]

You might try asking your doctor to prescribe Combivent/Duoneb.  This is an already prepared mixture of Albuterol and Ipratropium.  It is available as an inhaler, as well as a nebulizer solution.

Although you can ask your doctor to be sure, Pulmicort should probably be taken separately.

[Kestra]

You might try asking your doctor to prescribe Combivent/Duoneb.  This is an already prepared mixture of Albuterol and Ipratropium.  It is available as an inhaler, as well as a nebulizer solution.

Although you can ask your doctor to be sure, Pulmicort should probably be taken separately.

[caregiver222]

Mixing in a prepared solution such as recommended by Kestra is fine. The optimal protocol would involve using the albuterol first, then waiting five minutes and then the itratropium. Then fifteen minutes for the steroid. Also you should be taking an expectorant, such as Guinefeson. I hope I spelled that right. The concept is this. All the meds have some side effects, and some people are more sensitive to the side effects. Administering the medications separately maximizes the therapeutic potenial while minimizing the side effects. The albuterol opens op the passageways. The ipratropium then enters these passageways for a longer effect. Then the steroid enters for the longest effect. The Pulmacort should be taken a few minutes afterwards. If you violate these rules I don't see any life-threatening consequences, but generally you want to use the minumum amount of medication necessary to produce a desired therapeutic effect and separate administration of the meds accomplishes this goal.