Do you know how to use an inhaler correctly? Ineffective inhaler technique and mishandling of the devices are common problems, even among adults who have long-standing chronic obstructive pulmonary disease (COPD) or asthma.
The risk of improper technique is particularly high for older adults. And studies have shown that technique can deteriorate if it isn’t regularly revisited.
To help you brush up on proper inhaler techniques, follow the steps listed here. You should also review the specific instructions that come with your inhaler. If you’re still not sure you’re using the proper technique, don’t hesitate to ask your healthcare provider to watch you as you use it.
Get the most from your inhaler
The most common way to deliver inhaled medication is through a metered dose inhaler (MDI), a pressurized canister that releases an aerosol spray. Another option is to use a dry powder inhaler (DPI). A DPI delivers a fine powder to your lungs when you breathe in.
An MDI can be difficult to use because it requires coordination between the release of the medication and your inhalation. Even when it’s used correctly, most of the medication sticks to the back of the throat, and no more than 10 to 20 percent of it actually reaches the lungs.
The key to getting the most from your MDI is to use the proper technique. If you follow these steps, more of the medicine will reach your lungs.
1. Read the directions on the package insert about shaking and priming the inhaler (releasing a certain number of sprays in the air before you use the inhaler).
2. Place the metal canister into the plastic mouthpiece.
3. Remove the cap from the mouthpiece and shake the inhaler for 5 to 10 seconds.
4. Breathe out to the end of a normal breath (don’t force air out).
5. If your doctor recommends the open-mouth technique, hold the mouthpiece of the inhaler 1 to 2 inches (about the width of two fingers) from your mouth, tilt your head back slightly, and open your mouth wide. If your doctor recommends the closed-mouth technique, place the mouthpiece in your mouth with your lips sealed tightly around it.
For both techniques, breathe in slowly as you press down once on the metal canister to release a puff of medication.
6. Continue to inhale until your lungs are full (about five seconds). Inhaling too quickly will increase the amount of the medicine that sticks to the back of your throat.
7. Hold your breath for 10 seconds or as long as you can do so comfortably.
8. Before you exhale, be sure to remove the inhaler from your mouth and release your fingers from the canister.
9. Replace the cap on the mouthpiece in order to avoid contamination from dust and other particles.
10. For an additional dose, wait 1 minute and then repeat steps 3 through 9.
11. Clean the plastic mouthpiece once a week by removing the metal canister and rinsing the plastic portion in warm water; allow it to air dry. Replace the metal canister and the cap on the mouthpiece. Because the new inhalers tend to clog more easily, it’s especially important to clean them regularly. Check your inhaler’s package insert for specific cleaning instructions.
Consider a spacer or holding chamber
Spacers and holding chambers are devices that hold the medication for a few seconds after it has been released from the inhaler. This delay can be helpful for people who have difficulty coordinating their breathing with the use of an inhaler. Spacers and holding chambers are simple to use, can be fitted to most inhalers, and can be rigid or collapsible.
Both devices extend the mouthpiece of the inhaler and direct the medication to the back of the mouth.
The difference between the two devices is that the holding chamber is designed with a one-way flap that traps and suspends the medication long enough for you to inhale over 3 to 5 seconds.
That makes the holding chamber a good choice if you have a hard time triggering the MDI and breathing in at the same time. If you don’t have this problem, then a spacer is probably fine.
Whether you use a spacer or holding chamber, you’re likely to experience fewer sore throats and less hoarseness because both devices reduce the amount of medication that sticks to the back of your throat.
If you’re planning to buy a spacer or holding chamber, look for a static-free device. This type of spacer or holding chamber prevents a static charge that can cause the contents of the MDI to cling to the sides of the device instead of floating freely in the mist.
DPIs are available as single- and multiple-dose devices. With single-dose devices, the medication is contained in a capsule that you must place in the device immediately before each treatment.
One advantage of a DPI is that it’s not necessary to coordinate the release of the medication with your inhalation. A potential disadvantage is that you need to inhale more forcefully than with an MDI. Follow these instructions to ensure proper use.
1. Read the directions on the package insert before you use the inhaler.
2. Remove the cap. If you’re using a single dose device, insert the capsule as directed in the instructions.
3. Hold your mouth away from the inhaler device and exhale slowly and completely (to the end of a normal breath).
4. Place your teeth over the mouthpiece and seal your lips around it.
5. Inhale forcefully and deeply.
6. Remove the inhaler from your mouth and hold your breath for approximately 5 to 10 seconds.
7. Exhale slowly.
8. For an additional dose, wait 30 seconds and repeat the steps above.