Inhalers deliver medication directly to the lungs, allowing for rapid absorption and targeted treatment of respiratory conditions. The effectiveness of this treatment relies entirely on correct technique, as improper use is the most frequent reason treatment fails. When a dose is delivered incorrectly, the medication often lands on the back of the throat instead of reaching the deep airways where it is needed. Mastering the steps for your specific device ensures you receive the full therapeutic benefit of the prescribed drug.
Understanding Inhaler Types
The two main categories of inhalers require fundamentally different techniques for successful use. The Metered-Dose Inhaler (MDI), often called a “puffer,” delivers a burst of aerosolized medication using a chemical propellant. This type requires careful synchronization between pressing the canister and starting a slow inhalation.
The Dry Powder Inhaler (DPI) delivers medication as a fine powder without a propellant. DPIs are breath-actuated, meaning the device releases the dose when the user inhales. The technique for a DPI involves a quick and deep inhalation, which is the opposite of the slow breath required for an MDI.
Step-by-Step Guide for Metered-Dose Inhaler (MDI) Use
Proper MDI use requires several coordinated steps. If the inhaler is new or has not been used in over a week, it must be primed by shaking it well and spraying test puffs into the air, following the product instructions. Before each use, shake the inhaler vigorously for about five seconds to thoroughly mix the medicine and propellant.
Exhale fully away from the mouthpiece to empty your lungs. Place the mouthpiece in your mouth, sealing your lips tightly around it, or hold the inhaler about one to two inches in front of your open mouth. Begin a slow, deep inhalation through your mouth, and simultaneously press down on the canister once to release the medication.
The inhalation must be slow and steady to prevent the aerosolized particles from impacting the back of your throat. Continue inhaling until your lungs are full, then remove the inhaler from your mouth. Hold your breath for five to ten seconds, which allows the fine drug particles to settle deep within the lungs. If a second puff is prescribed, wait 30 to 60 seconds before shaking the inhaler and repeating the entire process.
Adapting Technique for Spacers and Dry Powder Inhalers (DPIs)
Using a Spacer
Spacers are holding chambers that attach to an MDI mouthpiece, simplifying the technique by eliminating the need for hand-breath coordination. The spacer holds the aerosolized medication in a reservoir, allowing the user to take a slow, deep breath without having to time the press and the inhale perfectly. To use, shake the inhaler, attach it to the spacer, exhale fully, and press the MDI canister once.
Breathe in slowly and deeply through the spacer’s mouthpiece until your lungs are full. If a deep breath is difficult, take four to five normal breaths (tidal breathing). If the spacer whistles, you are breathing in too quickly and should slow down the inhalation.
Using a Dry Powder Inhaler (DPI)
DPIs require a completely different approach because they are activated by the force of the user’s breath. After preparing the dose according to the specific device’s instructions, exhale completely away from the DPI to avoid introducing moisture. Place your lips tightly around the mouthpiece and inhale quickly and forcefully—a rapid, deep breath is necessary to draw the powder out of the device and into the lungs. Remove the DPI and hold your breath for five to ten seconds before exhaling slowly. DPIs should never be used with a spacer, and moisture must be kept away from the device as it can cause the powder to clump.
Post-Use Care and Troubleshooting Common Errors
Post-use care is important when using inhalers containing corticosteroids. Steroid medication can settle in the mouth and throat, potentially leading to a fungal infection called oral thrush. To prevent this, always rinse your mouth thoroughly with water and gargle after use, then spit the water out.
Regular cleaning prevents medication buildup that can clog the MDI’s mouthpiece. For most MDIs, remove the metal canister and wash the plastic casing under warm running water weekly, allowing it to air dry completely before reassembling. DPIs should never be washed with water; instead, wipe the mouthpiece with a dry cloth. Ensure you monitor the dose counter, if present, or manually track the number of puffs used to avoid running out of medication unexpectedly.