A Metered-Dose Inhaler (MDI) is a common handheld device that delivers a specific amount of medication directly to the lungs. These devices are frequently used to manage respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). Proper technique is essential for effective medication delivery. Incorrect use can lead to a significant portion of the medication settling in the mouth or throat, reducing its effect.
Step-by-Step Guide to Using Your MDI
Before each use, prepare your metered-dose inhaler. Remove the cap from the mouthpiece and check for any debris. Shake the inhaler thoroughly, typically 3 to 5 seconds, to ensure the medication and propellant are well mixed. If the inhaler is new or hasn’t been used for several days, you may need to “prime” it by releasing test sprays into the air away from your face, as indicated by the manufacturer’s instructions.
To begin the inhalation process, stand or sit upright and exhale completely. This creates space for a deep inhalation of the medication. Hold the inhaler upright with the mouthpiece at the bottom. Place the mouthpiece in your mouth, either sealing your lips tightly around it or holding it 1 to 2 inches away, as instructed by your device. Ensure your tongue does not block the spray.
As you inhale slowly and deeply through your mouth, firmly press down on the metal canister to release one puff. Continue inhaling slowly for 3 to 5 seconds until your lungs feel full. After inhaling, remove the inhaler from your mouth and hold your breath for 5 to 10 seconds. This allows the medication particles to settle in your airways.
Finally, exhale slowly. If your prescription requires more than one puff, wait 15 to 60 seconds between doses. Shake the inhaler again before the next puff. After using a steroid-containing inhaler, rinse your mouth thoroughly with water and spit it out to prevent oral side effects like thrush.
Using Your MDI with a Spacer
A spacer is a tube-like attachment for metered-dose inhalers, acting as a holding chamber for medication. This device assists individuals with coordination challenges, ensuring more medicine reaches the lungs and less settles in the mouth or throat. This improved delivery reduces potential side effects, particularly with corticosteroid inhalers.
To use your MDI with a spacer, remove caps from both devices, then insert the MDI into the spacer’s open end, keeping the inhaler upright. Shake the assembled unit. Before inhaling, exhale completely away from the spacer.
Place the spacer’s mouthpiece in your mouth, creating a tight seal with your lips, or ensure a mask fits securely. Press the MDI canister once to release medication into the spacer. Immediately inhale slowly and deeply through the mouthpiece. A whistling sound from some spacers indicates overly rapid inhalation.
After inhaling, hold your breath for 5 to 10 seconds to allow the medicine to settle. If multiple puffs are needed, wait 30 to 60 seconds between each dose. As an alternative to breath-holding, you can breathe normally through the spacer for 5 to 10 breaths after actuation.
Cleaning and Storing Your Inhaler
Regular cleaning of your metered-dose inhaler is important. This prevents clogging and maintains proper medication delivery. For most MDIs, clean the plastic case at least once a week. Begin by removing the metal canister from the plastic holder, being careful not to get the canister wet. Rinse the plastic case under warm running water for about 30 seconds, and some instructions also suggest using mild dish soap.
After rinsing, shake off any excess water and allow the plastic case to air-dry completely, ideally overnight. Avoid using a cloth to dry it, as this can leave lint or create static electricity. Once dry, reinsert the metal canister and replace the mouthpiece cap. Store your inhaler in a cool, dry place away from direct sunlight and extreme temperatures, ensuring the cap is on to prevent debris accumulation.
Troubleshooting and When to Seek Medical Advice
Sometimes, you might encounter issues with your metered-dose inhaler. If the inhaler doesn’t spray or seems to be delivering less medication, it might be clogged due to medication buildup, indicating a need for cleaning. Many MDIs now include a dose counter to help track remaining doses. Replace the inhaler when the counter reaches zero, even if it still produces a spray, as it may no longer contain medicine. For inhalers without a counter, diligently track your puffs and replace the device after the number of doses indicated on the product.
It is important to seek medical advice if your symptoms worsen despite proper inhaler use, or if you frequently need to use your rescue inhaler. Consult your healthcare provider if you experience persistent side effects, have concerns about your technique, or if your inhaler does not seem to be working effectively. They can review your technique, adjust your medication regimen, or address any underlying issues to ensure optimal respiratory management.