An asthma pump, or inhaler, is a compact device designed to deliver medication directly into the lungs for the management of respiratory conditions. This targeted approach allows a small, measured dose of medicine to quickly reach the airways, offering effective relief or control of symptoms. Proper technique is paramount because it ensures the medication reaches the lower airways, where it is needed, rather than settling in the mouth or throat. Learning the correct use of your specific device maximizes its therapeutic benefit.
Understanding Different Inhaler Types
Asthma pumps are categorized into two main types, each requiring a distinct method of inhalation for effective drug delivery. The Metered Dose Inhaler (MDI) delivers medication as a fine aerosol mist from a pressurized canister. MDIs contain the medicine dissolved or suspended in a chemical propellant, released upon actuation. This type requires careful coordination between pressing the canister and beginning a slow, steady breath.
The Dry Powder Inhaler (DPI) delivers the drug in a fine powder form without a propellant gas. DPIs are breath-actuated, meaning the dose is released only when the user inhales. Unlike MDIs, DPIs require a fast, deep, and forceful inhalation to pull the powder into the lungs. MDIs are often paired with a valved holding chamber, known as a spacer. The spacer holds the medication mist after release, eliminating the need for precise coordination and improving the amount of medicine that reaches the lungs.
Step-by-Step Guide for Metered Dose Inhalers
Using an MDI is simplified by incorporating a spacer, which is recommended for most users. Before use, check that the spacer is clean and shake the MDI canister vigorously for about five seconds to mix the medication. Insert the canister mouthpiece into the rubber opening at the end of the spacer, priming the inhaler if necessary.
Prepare your lungs by exhaling fully, pushing air out away from the device. Place the spacer mouthpiece between your teeth and seal your lips tightly around it. Press down on the MDI canister once to release a single puff into the chamber. Immediately begin to inhale slowly and deeply through your mouth for about five to seven seconds.
If the spacer whistles, you are inhaling too quickly, and the medication may deposit in your throat. Once your lungs are full, remove the spacer and hold your breath for up to ten seconds, or as long as comfortable. Holding your breath allows the medication particles to settle deep within the airways. Wait approximately one minute before administering any subsequent doses. If the medication is an inhaled corticosteroid, rinse your mouth with water and spit it out to reduce the risk of oral thrush.
Using Dry Powder Inhalers
Dry Powder Inhalers require a technique fundamentally different from the slow inhalation used with an MDI and spacer. The first step involves preparing the dose, such as loading a capsule or clicking a mechanism, depending on the DPI model. DPIs should never be shaken, as this can disrupt the measured powder dose inside the device.
Exhale completely away from the inhaler before placing the mouthpiece in your mouth. The difference lies in the speed and force of the next breath, as the DPI relies entirely on the strength of your inhale to pull the powder out. You must inhale quickly, deeply, and forcefully through the mouthpiece to activate the device and draw the medicine into your lungs.
After rapid inhalation, remove the inhaler and hold your breath for five to ten seconds to allow the powder to deposit deep in the airways. Do not breathe out into the DPI mouthpiece, as moisture can cause the dry powder to clump and clog the device. Since DPIs do not contain propellant, you may not feel or taste the dose, but forceful inhalation ensures delivery.
Storage, Cleaning, and Dose Tracking
Maintaining your asthma pump requires proper storage and routine cleaning to ensure the medication remains effective and the device functions correctly. All inhalers should be stored at room temperature, away from extreme heat or cold, which can affect the medicine or propellant pressure. DPIs and their powder formulations must be stored in a dry place, avoiding damp environments like a bathroom, as moisture can cause the powder to clump.
Cleaning Inhalers and Spacers
For Metered Dose Inhalers, clean the plastic casing weekly by removing the metal canister and rinsing the plastic parts under warm running water. The canister must never get wet, and the plastic case must air dry completely before reinsertion. Dry Powder Inhalers should never be washed with water; instead, gently wipe the mouthpiece with a dry cloth to remove residue. Spacers should be cleaned weekly by soaking the parts in warm, soapy water for about fifteen minutes, rinsing thoroughly, and allowing them to air dry without wiping.
Tracking Doses
Many modern inhalers have a built-in dose counter, and the device should be replaced when the counter reaches zero. For inhalers without a counter, manually track usage by noting the total doses printed on the canister and calculating the depletion date based on daily use. Do not attempt to determine if an MDI is empty by floating the canister in water, as this method is inaccurate and can damage the device. Request a refill well before your current inhaler is depleted.