Suggest treatment for coughing up of mucus despite taking Albuterol
Patient: My 78 year old mother has the flu which caused Copd exacerbation. She is taking Cipro and was given guaifenesin with codeine cough syrup. She has been fever free for 3 days now. She also was put on a prednisone taper starting at 60mg for 2 days 50 mg for 2 days and now we are down to 40 mg tapering down over a week and then going down 10 mg per week. she also take Spiriva once daily and symbicort 2 puff twice daily. Along with albuterol breathing nebulizer treatment about 4 times per day. She is eating well but is still fatigued. She is on 02 2.5 liters per nasal cannula during the day and bipap at night. She still has mucus which is hard for her to cough up. Her 02 sats are between 90-95% with O2. my question is concerning the cough syrup and whether I should continue to give it too her. Would it be better just to give her guaifenesin alone without the codeine? She had a chest xray a week a ago from Saturday no pneumonia was noted. She is also very confused but I know that goes with the disease process and meds. Do you have any suggestions she has been sick for a couple week now. Doctor: Hello and Welcome to ‘Ask A Doctor’ service.  I have reviewed your query and here is my advice.  According to history don't worry. Usually in COPD, it is nearly normal to have sputum. However, if you think that this is not so normal for her situation than better to do a chest X-ray.   Regards, Dr.Jolanda