Albuterol is a short-acting bronchodilator designed to quickly relax the muscles surrounding the airways in the lungs. This action opens the bronchial tubes, providing rapid relief from acute symptoms such as wheezing, chest tightness, and shortness of breath associated with asthma or Chronic Obstructive Pulmonary Disease (COPD). The medication is delivered using a Metered-Dose Inhaler (MDI), a handheld device that administers a fixed dose of medicine as an aerosol spray. Mastering the proper technique for using the MDI is necessary to ensure the medication reaches the lungs. Incorrect use can result in the medicine settling in the mouth or throat, leading to ineffective symptom control.
Preparing the Inhaler and Yourself
The preparation phase for using an MDI begins well before the device is brought to the mouth. Users should check the dose counter, if available, to ensure sufficient medication remains. Remove the cap from the mouthpiece and inspect the opening to confirm it is clean and free of debris.
Before each use, the canister must be shaken vigorously for about five seconds to ensure the drug suspension is evenly mixed. If the inhaler is brand new or has not been used for two weeks or more, it needs to be “primed.” This involves spraying a test puff into the air, away from the face, to guarantee the correct dose is released. Finally, exhale fully and slowly, pushing as much air out of the lungs as possible before placing the mouthpiece.
The Correct Inhalation Technique
The most important part of MDI use is coordinating the release of the medication with the act of breathing in. After exhaling, place the mouthpiece into the mouth, sealing the lips tightly around it. Begin a slow, deep inhalation through the mouth, and at the same moment, firmly press down once on the canister. The inhalation should be steady and continuous, lasting about three to five seconds, drawing the medicine deep into the lower airways.
After inhalation, remove the inhaler and hold the breath for up to ten seconds, or as long as is comfortable. This pause allows the microscopic medicine particles time to settle in the lungs before slowly exhaling. If a second puff is required, shake the inhaler again, and repeat the entire process.
Using a Spacer Device
Many healthcare providers recommend using a spacer device, which is a plastic tube that attaches to the MDI mouthpiece. The spacer acts as a holding chamber for the medication, solving the problem of poor hand-breath coordination. With a spacer, the user presses the canister to release the medicine into the chamber, then breathes in slowly and deeply from the spacer’s mouthpiece.
The spacer reduces the velocity of the aerosol spray, allowing the particles to slow down and evaporate less quickly. This results in a higher percentage of the medicine reaching the lungs, instead of coating the mouth and throat. The spacer is particularly helpful for children or adults who struggle to time their breath with the canister press.
Post-Use Care and Cleaning
Regular maintenance of the MDI device is necessary to prevent the buildup of medication residue, which can block the outlet and lead to inconsistent dosing. The plastic actuator, which holds the metal canister, should be cleaned at least once a week. To clean it, first remove the metal canister and the cap, ensuring the canister remains completely dry.
Rinse the plastic actuator under warm running water for about 30 seconds, allowing the water to flow through both the top and the mouthpiece end. Avoid using soap or harsh detergents, as these can damage the plastic or leave residues. After rinsing, shake off excess water and allow the actuator to air dry completely, ideally overnight, before reassembling the device. Proper storage involves keeping the inhaler at room temperature, away from direct heat or extreme cold.
Dosage Limits and When to Seek Medical Help
Albuterol is a rescue medication, and its use should follow the physician’s instructions, typically two puffs every four to six hours as needed for symptoms. If a second puff is required, a full minute must pass before administering it. Exceeding the prescribed frequency or dosage, which usually should not surpass twelve puffs in a 24-hour period, can increase the risk of side effects like shakiness, rapid heartbeat, or nervousness.
An increasing need to use the inhaler indicates that the underlying respiratory condition is worsening and requires medical re-evaluation. If symptoms do not improve after a standard dose, or if the inhaler is needed more frequently than every four hours, a doctor should be contacted promptly. Emergency medical attention is required if there is severe shortness of breath, chest pain, or blue discoloration of the lips or fingernails.