<s>[INST] Have copd ,and for a month have had bronchitis . My dr. gave the cocktail shot and cefdinir ,also using albutrol in nebulizer every 4 hours and Adair 2x a day. 2weeks later extreme soreness in chest underarms and upper back,very congested , hurts to breathe. Having trouble recling from the soreness, feels like bones are broke in chest and back. Went back to dr. Got rohcefrin shot and prescribed budesonide also to use in nebulizer. How often should I use the budesonide? [/INST] Thanks for your question on HCM. By your history and description, you are having acute exacerbation of COPD (chronic obstructive Pulmonary disease). And infection is the most common cause for COPD exacerbation. Your symptoms like cough, chest congestion etc favours lung infection more. Control of infection should be priority to treat exacerbation. So consult pulmonologist and get done sputum culture and sensitivity report. Culture will isolate the organism and sensitivity report will guide you about effective antibiotic therapy. Budesonide is inhaled steroid and should be taken twice daily. Along with budesonide, you should also take nebulization of LABA (long acting beta 2 agonist). This will give you more symptomatic relief. Also start chest physiotherapy, mucolytics, expectorant and anti inflammatory drugs, to relieve chest congestion. So consult pulmonologist and discuss all these. </s>