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How to use an inhaler - no spacer

Metered-dose inhaler (MDI) administration - no spacer; Bronchial nebulizer; Wheezing - nebulizer; Reactive airway - nebulizer; COPD - nebulizer; Chronic bronchitis - nebulizer; Emphysema - nebulizer

Using a metered-dose inhaler (MDI) seems simple. But many people do not use them the right way. If you use your MDI the wrong way, less medicine gets to your lungs and most remains in the back of your mouth. If you have a spacer, use it. It helps get more medicine into your airways.

(The instructions below are not for dry powder inhalers. They have different instructions.)

Getting Ready

  • Shake the inhaler hard before each use.
  • Take the cap off.
  • Look inside the mouthpiece and make sure there is nothing in it.
  • If you have not used the inhaler in a while, you may need to prime it. See the instructions that came with your inhaler for when and how to do this.
  • Breathe out all the way. Try to push out as much air as you can.
  • Hold the inhaler with the mouthpiece down. Place your lips around the mouthpiece so that you form a tight seal.

Breathe in Slowly

  • As you start to slowly breathe in through your mouth, press down on the inhaler one time.
  • Keep breathing in slowly, as deeply as you can.

Hold Your Breath

  • If you can, hold your breath as you slowly count to 10. This lets the medicine reach deep into your lungs. Breathe out slowly through your mouth.
  • If you are using inhaled, quick-relief medicine (beta-agonists), wait about 1 minute before you take your next puff. You do not need to wait a minute between puffs for other medicines.
  • Put the cap back on the mouthpiece and make sure it is firmly closed.
  • After using your inhaler, rinse your mouth with water, gargle, and spit. Do not swallow the water. This helps reduce side effects from your medicine.

Keep Your Inhaler Clean

Look at the hole where the medicine sprays out of your inhaler. If you see powder in or around the hole, clean your inhaler.

  1. Remove the metal canister from the L-shaped plastic mouthpiece.
  2. Rinse only the mouthpiece and cap in warm water.
  3. Let them air dry overnight.
  4. In the morning, put the canister back inside. Put the cap on.
  5. DO NOT rinse any other parts.

Replacing Your Inhaler

Most inhalers come with counters on the canister. Keep an eye on the counter and replace the inhaler before you run out of medicine.

DO NOT put your canister in water to see if it is empty. This does not work.

Bring your inhaler to your clinic appointments. Your doctor can make sure you are using it the right way.

Storing Your Inhaler

Store your inhaler at room temperature. It may not work well if it is too cold. The medicine in the canister is under pressure. So make sure you do not get it too hot or puncture it.

References

Laube BL, Dolovich MB. Aerosols and aerosol drug delivery systems. In: Adkinson NF Jr, Bochner BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 66.

National Asthma Education and Prevention Program website. How to use a metered-dose inhaler. www.nhlbi.nih.gov/health/public/lung/asthma/asthma_tipsheets.pdf. Updated March 2013. Accessed February 28, 2018.

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  • How to use an asthma inhaler

    Animation

  •  

    How to use an asthma inhaler - Animation

    Inhalers of one kind or another are often the mainstay of asthma therapy. I'm Dr. Alan Greene and let's talk about how to actually use an inhaler. When someone is first handed an inhaler, their first instinct is often to put their mouth around the opening and to squeeze. But it turns out when you do it that way you'll often end up with a lot of the medicine inside your mouth, on your tongue, on the roof of the mouth and inside the cheeks. You get less medicine down into the lungs where it's needed. It tastes bad, and if it happens to be one of the preventive kinds of medications, it can actually lead to thrush or yeast in the mouth. So, the way that we usually recommend is to hold it close to your mouth and begin breathing in through your mouth so you get a good airstream going straight in and down into your lungs. And once you got that going, then squeeze like this. And then close your mouth from then to keep it in there. Now something else that's worth noting. An even better way to use an inhaler is with a spacer. We especially recommend this for kids, but it's better for adults, too. And the way the spacer works - you don't have to be coordinated. You don't have to time it perfectly. You can put the spacer into your mouth and you squirt the medicine into the spacer and just breathe in and out normally for awhile so the medicine keeps coming in. Now whatever you use whether it's a straight inhaler or the spacer there is a recent change that's worth being aware of. For a long time, asthma inhalers were propelled by CFCs (chlorofluorocarbons) that caused some problems with global warming and ozone depletion. Those have now been replaced or are being replaced with something called HFA instead. That's great for the environment but it is a little bit clumpier. So it's important, the little place where the medicine comes out of, you may need to clean off on an albuterol kind of inhaler, whether you're using a spacer or doing it directly into your mouth.

  • Inhaler medication administration - illustration

    An inhaler is a quick way of administering medicine directly into the bronchial passageways to promote clearer breathing.

    Inhaler medication administration

    illustration

  • How to use an asthma inhaler

    Animation

  •  

    How to use an asthma inhaler - Animation

    Inhalers of one kind or another are often the mainstay of asthma therapy. I'm Dr. Alan Greene and let's talk about how to actually use an inhaler. When someone is first handed an inhaler, their first instinct is often to put their mouth around the opening and to squeeze. But it turns out when you do it that way you'll often end up with a lot of the medicine inside your mouth, on your tongue, on the roof of the mouth and inside the cheeks. You get less medicine down into the lungs where it's needed. It tastes bad, and if it happens to be one of the preventive kinds of medications, it can actually lead to thrush or yeast in the mouth. So, the way that we usually recommend is to hold it close to your mouth and begin breathing in through your mouth so you get a good airstream going straight in and down into your lungs. And once you got that going, then squeeze like this. And then close your mouth from then to keep it in there. Now something else that's worth noting. An even better way to use an inhaler is with a spacer. We especially recommend this for kids, but it's better for adults, too. And the way the spacer works - you don't have to be coordinated. You don't have to time it perfectly. You can put the spacer into your mouth and you squirt the medicine into the spacer and just breathe in and out normally for awhile so the medicine keeps coming in. Now whatever you use whether it's a straight inhaler or the spacer there is a recent change that's worth being aware of. For a long time, asthma inhalers were propelled by CFCs (chlorofluorocarbons) that caused some problems with global warming and ozone depletion. Those have now been replaced or are being replaced with something called HFA instead. That's great for the environment but it is a little bit clumpier. So it's important, the little place where the medicine comes out of, you may need to clean off on an albuterol kind of inhaler, whether you're using a spacer or doing it directly into your mouth.

  • Inhaler medication administration - illustration

    An inhaler is a quick way of administering medicine directly into the bronchial passageways to promote clearer breathing.

    Inhaler medication administration

    illustration

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Review Date: 2/18/2018

Reviewed By: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. 01-22-19: Editorial update.

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