Message Boards for the CF Trust

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sally 1

Posts: 128
From: oldham
Registered: 09-Nov-2006

promixin before or after DNase?
Posted: 05-Dec-2006 19:49

Reply

The Ineb rep has just been round helping Tom sort out his Ineb (cleaning etc). Whilst talking we discussed how DNase works. He then said Tom should take DNase bofore Promixin. He has been doing it the other way round for years and I am sure that is what we were told. He rang a patient at Brompton who takes DNase first.

Help

a confused

Sal

Rubabes

Posts: 32
From: North East
Registered: 13-Nov-2006

Re: promixin before or after DNase?
Posted: 05-Dec-2006 19:57

Reply

Hi,
I was told DNase first about an hour before physio to thin the mucus (yuk!!), then physio then finally nebulised antibiotic.

The reasoning is dnase before physio helps you clear more during physio and if you have the antibiotic first you cough it out during physio.

I've had varying times given about when to take dnase in relation to physio but have always been told to do the antibiotic last.

Hope this makes sense! I'm starting to confuse myself!!!

love Rubabes x

sally 1

Posts: 128
From: oldham
Registered: 09-Nov-2006

Re: promixin before or after DNase?
Posted: 05-Dec-2006 20:12

Reply

Thanks. That fit with what man from Ineb said. Also he said the DNAse puts holes in the mucoid covering of pseudomonas and allows the antibiotic to get through and kill the Pseudomonas.
Now feeling worried
sal

sally 1

Posts: 128
From: oldham
Registered: 09-Nov-2006

Re: promixin before or after DNase?
Posted: 05-Dec-2006 22:17

Reply

bumping post

sandylizz

Posts: 97
From: Shrewsbury
Registered: 10-Nov-2006

Re: promixin before or after DNase?
Posted: 05-Dec-2006 22:40

Reply

Ive been tole the same for years..
Dnase and hr before physio then antibiotic after physio for the same reason as already given..

xx Sandy xx

fool

Posts: 16
Registered: 06-Nov-2006

Re: promixin before or after DNase?
Posted: 05-Dec-2006 23:16

Reply

i wouldnt worry too much - for years i had been doing all my nebs in one go! ventolin, followed by dnase followed by colomycin.

at a later date i was told i should be doing it the dnase and ventolin, followed by physio and coloymcin.

the wierd thing is i was told dnase wouldnt work efficiently at the same time as colomycin - but it seemed to work ok for me at the time. I could certainly feel the effects of the dnase.

althought you have guidelines, everyone is different and different things work for different patients. for example i always do my dnase and hypertonic saline in the evening - often before bed as it seems best to work for me then.

Basically this is my long-winded way of saying if it works and you have a rountine its fine - much better than not doing it at all!

sorry this post seems to be a bit waffle-y xxx

sunseasand

Posts: 74
Registered: 10-Nov-2006

Re: promixin before or after DNase?
Posted: 06-Dec-2006 08:58

Reply

Hi, My son is on promixin, but I ask his consultant about him going on DNAse as well and he is saying it may not benefit him at the moment. I have noticed that a lot of you guys are on DNAse, why did your consultant give it you and is it expensive? from sunseasand.

sally 1

Posts: 128
From: oldham
Registered: 09-Nov-2006

Re: promixin before or after DNase?
Posted: 06-Dec-2006 12:45

Reply

thanks folks. I'm going to get tom to ask the dr at hospital tomorow. If it needs to be swapped it doesn't matter as he has always left a gep between the two anyway.
suneasand
DNAse is expensive but that shouldn't make a difference and if that is their reason for not giving it then you may have a fight on your hands. Tom was given it aged 4 or 5 and did not fit the criteria but I know it made a difference to his overall wellbeing. I'm not sure why she gave it to him except that she felt he may have benefitted. It was very new at the time.His doctor at the time was Barbara Phillips and frankly, was the bees' knees. I would wonder why they say he shouldn't have it.

Good luck

sal

Rubabes

Posts: 32
From: North East
Registered: 13-Nov-2006

Re: promixin before or after DNase?
Posted: 06-Dec-2006 15:09

Reply

Hi Sunseandsand,
I was given DNase when it first came out because my GP wanted to see if this new medicine was good!! How rare is that?? At that point my function was Ok (but less than 70%). It is now 35% - my consultant says take it in case it helps.

I may be wrong but I would guess it may be less effective in people whose function is excellent(100%+). I hope that's the reason they decided not to prescribe it for your son!! It is very expensive and I beleive that when it first came out there wasn't conclusive evidence that it works over the whole range of lung functions - perhaps there may by now have been further studies. Why don't you ask your consultant what the patients health needs to be for him/her to prescribe it? They do have to weigh up the pros and cons, it may be that at this stage your son won't benefit enough to to make it worth having yet another medicine to take! Here's hoping its not the cost thats stopping them prescribing as that's another battle to fight..

love Rubabes x

sunseasand

Posts: 74
Registered: 10-Nov-2006

Re: promixin before or after DNase?
Posted: 06-Dec-2006 17:46

Reply

Thanks for that guys, is lung function is quite good I suppose, it is around 80%. I have sort of asked his consultant a few times but he sort of mutters that it is in the pipeline and we will give it if he needs it. He also said it helps pwcf who have really thick mucus, but I wonder how do they know that with a cf person. My son has always got a cough and he finds it hard to cough up phlegm, but I can here it rattling on his chest. I think I will try and ask for more reasons why he cannot have it.He is 14 and has had pseudomonas twice now. from sunseasand.