Combivent

[Sparda29]

So now that the regular Combivent is off the market and has been replaced with this bull**** propellant free stuff, what is your hospital doing about it? We just switched everyone over to duoneb nebulized but a lot of physicians are bitching about this and want us to carry it.

Can it be used with ventilated patients (which is the only time we used Combivent in the first place)?

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[pharmalt82]

So now that the regular Combivent is off the market and has been replaced with this bull**** propellant free stuff, what is your hospital doing about it? We just switched everyone over to duoneb nebulized but a lot of physicians are bitching about this and want us to carry it.

Can it be used with ventilated patients (which is the only time we used Combivent in the first place)?

I think you may need a new ventilator adapter for this. Although, I must say I like the respimat more so than all the other inhalers out there because it is idiot-proof on an outpatient basis.

 

[joetrisman]

why do your docs care?

 

[Sparda29]

They seem to not like Duoneb nebulized.

 

[bacillus1]

We use the Respimat. I think the drug reps inserviced most of the nurses. The pharmacists do Respimat teaching prior to discharge for those units where there is a discharge pharmacist.

 

[mustang sally]

Albuterol + Spiriva

 

[spacecowgirl]

Albuterol + Spiriva

Same.

Duonebs using some adapter thingie I don't quite understand for vented patients. They probably don't like nebs because it is different and no one asked their permission.

A better question is - why is anyone using scheduled Combivent? And if you're using PRN Combivent

 

[bacillus1]

Same.

Duonebs using some adapter thingie I don't quite understand for vented patients. They probably don't like nebs because it is different and no one asked their permission.

A better question is - why is anyone using scheduled Combivent? And if you're using PRN Combivent

Actually per our formulary, you have to fail scheduled ipratropium or Combivent in order to qualify for Spiriva. I guess Combivent is cheaper.

 

[spacecowgirl]

Actually per our formulary, you have to fail scheduled ipratropium or Combivent in order to qualify for Spiriva. I guess Combivent is cheaper.

No, it's not. There is no institutional size of Combivent, but there is for Spiriva. You need to look at your formulary again, it's about $230 vs $60.

 

[bacillus1]

No, it's not. There is no institutional size of Combivent, but there is for Spiriva. You need to look at your formulary again, it's about $230 vs $60.

VA pricing is much different than standard pricing. Also, I know there's an institutional size of Spiriva, but then they would be on Spiriva when they are discharged and through many years as an outpatient, so that makes it more expensive I guess, as the majority of the meds we fill are most likely outpatient meds.