Today we’ll talk about:
•    Inhaler technique for Metered Dose Inhaler (MDI)
•    How to clean and store your MDI
•    How to tell how many doses are left in your MDI

If you have diabetes, you wouldn’t be sent home with insulin, needles and syringes without 1.) being taught how to use them, and 2.) making sure a trained health care professional watches as you demonstrate that you’re able to use them correctly.

But who shows you how to use a MDI? In an informal survey, doctors were asked if they provide inhaler instruction. Each of them said that the pharmacist does it.  When those very pharmacists were asked if they provide inhaler instruction every single one said that the doctor does it. This is a problem and that’s why we’re talking about inhaler technique.

Here’s a short scene about MDI use from an episode of the television show “House.”

I’m sure you know that the lady in this video was not using her inhaler correctly! But seriously, even smart people who are ‘good’ patients should have MDI instruction. Demonstrate your inhaler technique to a licensed Respiratory Therapist or a nurse who specializes in COPD and ask if you are using good technique. Ask also how you can avoid unwanted side effects.

There are two main types of delivery for inhaled medication: Metered dose inhalers (MDIs) and dry powder inhalers (DPIs). We’ll discuss DPIs in Part IV of this series. A metered dose inhaler consists of a pressurized canister, an L-shaped plastic sleeve with a mouthpiece and cap on one end. Medication in a MDI comes out as a spray mist. When using a MDI it is best to use a spacer or holding chamber.

Use of MDI with Spacer or Holding Chamber
Using a MDI with a spacer or holding chamber helps you get the maximum amount of inhaled medicine into your lungs. The spray from a MDI comes out very fast and nobody can breathe the medicine in as fast as it comes out. Also, it’s difficult to position the inhaler so the medicine goes deep into your lungs. A spacer or holding chamber helps hold the mist for a short time so you can breathe it in more slowly, and position it well to get the medicine deeper into your lungs.

It’s common for people to feel they’re “not getting anything” when using a spacer or holding chamber. But, think about this: If you’re feeling the spray on your throat and your tongue, it is not getting down into your lungs where it belongs. You don’t have to feel the spray in order for it to work.

A spacer simply creates space between the MDI spray and your mouth. A spacer can be a simple tube 1-5 inches long, and can be made from something as ordinary as a clean cardboard tube from a roll of paper towels. See the end of this sharepost for a video demonstration.

A holding chamber is more than just a tube. It has one or more valves, helping control the flow of medicine according to your breathing effort. A holding chamber requires a doctor’s prescription. See the end of this sharepost for a video demonstration.