Inhalers are medical devices designed to deliver medication directly to the lungs and airways, offering rapid and targeted treatment for respiratory symptoms. They are most commonly used to manage chronic conditions like asthma or Chronic Obstructive Pulmonary Disease (COPD), which often cause a persistent cough. For the medication to work effectively, it must reach the small airways deep within the lungs. Proper inhalation technique is a determinative factor in treatment success, ensuring the dose is absorbed where it is needed most.
Understanding Device Types and Purpose
The two main categories of personal inhalers are Metered-Dose Inhalers (MDIs) and Dry Powder Inhalers (DPIs). MDIs use a chemical propellant to deliver a measured dose of medication as a fine mist or spray. These typically contain bronchodilators, such as short-acting beta-agonists, which quickly relax the smooth muscles around the airways to open the breathing passages.
DPIs contain the medication in a powdered form without a propellant. These devices rely entirely on the user’s forceful, quick inhalation to draw the powder out of the device and into the lungs. Medications delivered by both types often include inhaled corticosteroids, which reduce inflammation and mucus production, treating the underlying irritation that causes a cough. Understanding the specific mechanism of your device is necessary because the required breathing technique changes between the two types.
Step-by-Step Proper Inhalation Technique
Using a Metered-Dose Inhaler requires coordinated effort to ensure the medication reaches the lungs instead of settling in the back of the throat. Before use, the canister should be shaken vigorously for about five seconds to mix the drug and the propellant. After exhaling fully away from the device, position the mouthpiece and begin a slow, deep inhalation through the mouth. Press the canister down only after the inhalation has begun, continuing the slow breath for three to five seconds until the lungs are full. The breath should then be held for up to ten seconds to allow the medication particles to settle in the airways before slowly exhaling.
Dry Powder Inhalers demand a rapid and forceful inspiratory flow to de-aggregate the powdered medication. First, the device must be loaded or prepared according to its specific instructions, such as clicking a lever or inserting a capsule. Exhale fully away from the DPI to avoid introducing moisture, which can cause the dry powder to clump. Placing the mouthpiece to the lips, take a quick, deep, and forceful breath to ensure the powder is successfully drawn into the lungs. After removing the DPI, the breath should be held for five to ten seconds for the powder to deposit deep within the airways.
Optimizing Delivery with Spacers and Strategic Timing
For Metered-Dose Inhalers, using a spacer or valved holding chamber can significantly improve medication delivery. The spacer is a tube that attaches to the MDI, acting as a reservoir that holds the aerosolized medication after the puff is released. This eliminates the need for precise hand-breath coordination, allowing the user to inhale the dose slowly and steadily. Spacers also reduce the amount of medication that impacts the back of the throat, minimizing local side effects like hoarseness or oral thrush when using inhaled corticosteroids.
Strategic timing of inhaler use can optimize the therapeutic effect, especially for coughs related to specific triggers. For instance, if symptoms are triggered by exercise, a bronchodilator may be taken 15 to 30 minutes before starting the activity. If a treatment plan calls for multiple puffs of an MDI, waiting 30 to 60 seconds between actuations is advisable. This allows the first dose to begin opening the airways, enabling the second dose to travel deeper into the lungs.
Post-Use Care and Troubleshooting Device Issues
Proper hygiene after using an inhaler is important when the medication contains an inhaled corticosteroid. These steroid compounds can leave residue in the mouth and throat, increasing the risk of developing a fungal infection known as oral thrush. To prevent this, users must rinse their mouth with water and gargle immediately after each use, then spit the water out without swallowing it. This action removes the residual steroid particles, protecting the oral mucosa.
Regular cleaning of the inhaler device is necessary to prevent medication buildup from obstructing the mouthpiece. For MDIs, the plastic actuator should be removed from the metal canister and rinsed under warm running water at least once a week, then allowed to air dry completely. Dry Powder Inhalers should never be washed with water because moisture can ruin the powdered medication; instead, the mouthpiece should be wiped regularly with a clean, dry cloth. Most devices now include a dose counter, making the old method of floating the canister in water unreliable for troubleshooting an empty MDI. If the device is not providing relief, or if the dose counter reaches zero, the inhaler should be replaced and a healthcare provider consulted if symptoms persist.