How to use an inhaler

If you require the use of an inhaler, did it ever occur to you that you might be using it incorrectly? This oversight could potentially make your medication less effective while increasing your risk of a respiratory event. Deb Lulling, BSN, RN, Community Nursing Supervisor, Parkview Health, helps explain the step-by-step process and proper technique when using an inhaler, plus important information regarding the care and maintenance of your device.

There are many different types of inhalers to help manage respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), emphysema and chronic bronchitis. Regardless of the type of inhaler you use, it’s important you understand what medication is in your inhaler, how that medication helps manage your disease symptoms, the best ways to store or maintain your device, and most importantly, how to use it correctly.

Different parts of an inhaler

• Canister:  The canister will tell you the name of the medication, number of doses, the propellant being used, expiration date, storage instructions and special warnings. It’s best to store your inhaler at room temperature to ensure the medication remains stable. Also, if your inhaler expires, you should replace it as soon as possible but be sure to hold on to your old one in case of an emergency until your new one arrives.
• Actuator:  This is the plastic casing that holds the canister of your medication. It has a valve to help spray and disperse the medication. Many inhalers also have a counter on it to help you keep track of doses left. Usually need rinsed in warm water under faucet and air-dried once a week. Remember to always read cleaning or care instructions that come with your inhaler.
• Mouthpiece:  Located at the base of the actuator, the mouthpiece is where the medication will be delivered. It’s important to always check the mouthpiece before each use to ensure it’s clean and there’s no debris obstructing the opening and path of the medication.
• Cap:  The last part of your inhaler, located at the end of the mouthpiece, is the cap. This should always remain on your device except when in use. Staying vigilant in this practice will protect your inhaler from dust and other debris that could contaminate it.

How to prime your inhaler

Priming is a simple, yet important step in preparing your inhaler for use. Ideally, this should be done prior to the initial use of your device, but also if you haven’t utilized your inhaler for an extended period. Typically, you should re-prime your inhaler if it’s been two weeks or more, but this could vary depending on the medication in your Metered Dose Inhaler (MDI). Also, most inhalers have a few extra doses for priming purposes, so you don’t need to worry about wasting any of your medication. Here are the basic steps to prime your inhaler, but we also encourage you to read the priming instructions that accompany your specific device and medication:

1. Remove the cap from your inhaler.
2. Shake your inhaler for 3-5 seconds (ensuring the propellant and medication are mixed together).
3. With the inhaler facing away from you, spray it. Repeat this process 2 more times or follow the instructions specific to your inhaler.
4. When priming is complete the counter should read 200.

How to use your inhaler

Its recommended that you use your MDI with a spacer, which is simply a holding chamber for your medication. There is evidenced-based research showing the use of a spacer helps your inhaler deliver over 50% more medication directly into your lungs. Using a spacer is important because it helps slow down the medication, so it can go into your lungs rather than hitting your tongue, back of mouth and throat. Spacers are beneficial to people who struggle with proper hand-breath coordination that an MDI requires to be effective. To use your inhaler with a spacer you can follow these simple steps:

1. Remove the cap from your inhaler.
2. Shake your inhaler for 3-5 seconds.
3. Connect the mouthpiece of your MDI to the spacer.
4. Sit or stand up tall, allowing your lungs to expand.
5. Tilt your head slightly back to open your airway.
6. Exhale, away from the spacer, to empty your lungs.
7. Place your mouth and your teeth around the spacer mouthpiece.
8. Press the inhaler and start to breathe in deeply and slowly over 3-5 seconds.
9. Hold your breath for and count to 10, allowing the medication to enter your lungs.
10. Exhale slowly.
11. If a second puff is needed, repeat steps 1-10. Also, remember to wait at least 30-60 seconds before repeating the process. This allows the first dose of medication to take effect by opening your airways, then the second dose can be delivered deeper into your lungs.

With so many types of inhalers on the market, it’s important to read all the instructions on how to properly use, prime, clean and store your device. Also, be sure to speak with your primary care provider or pharmacist if you have any questions regarding your inhaler or respiratory medications.