An inhaler is a small, handheld device designed to deliver medication directly into the lungs through a person’s breathing. This method allows the medication to reach the airways efficiently, providing targeted treatment and potentially reducing side effects compared to oral medications. Effective use of an inhaler is important to ensure the full therapeutic benefit of the medicine and to manage respiratory conditions.
Identifying Your Inhaler
Inhalers come in various forms, but two primary types are commonly used: Metered-Dose Inhalers (MDIs) and Dry Powder Inhalers (DPIs). An MDI typically appears as an L-shaped plastic case holding a metal canister, which releases medication as a fine mist or spray. DPIs vary in shape, often appearing as disk-shaped or tube-shaped devices, and deliver medication as a dry powder without a chemical propellant. A less common third type is the soft mist inhaler, which converts liquid medicine into a slow-moving mist. Understanding your specific inhaler type is important as usage instructions differ.
Using a Metered-Dose Inhaler
Begin by removing the cap and shaking the inhaler vigorously for about 5 to 10 seconds to mix the medicine and propellant evenly. If it is a new inhaler or has not been used for several days, prime it by test spraying into the air according to the manufacturer’s instructions. Exhale fully to empty your lungs, then place the mouthpiece in your mouth, sealing your lips tightly around it. As you begin to inhale slowly and deeply, press down firmly on the canister to release a puff of medicine, continuing to breathe in for 3 to 5 seconds.
Holding your breath for about 10 seconds after inhalation allows the medicine to settle in your lungs. Slowly exhale once you have held your breath for the recommended time. A spacer device, a tube that attaches to the MDI, is often recommended, especially for children or those who find coordinating their breath with the inhaler difficult. Spacers help deliver more medication to the lungs by holding the mist, allowing for slower, deeper inhalation and preventing much of the medicine from settling in the mouth or throat. If a second puff is needed, wait about 30 seconds to 1 minute before repeating the steps.
Using a Dry Powder Inhaler
Dry Powder Inhalers (DPIs) operate differently from MDIs and generally do not require shaking or a spacer. First, prepare the dose according to your inhaler’s specific instructions, which might involve twisting a part of the device, sliding a lever, or loading a capsule. It is important not to breathe into the device, as moisture can cause the powder to clump and clog the inhaler.
After loading the dose, exhale fully away from the inhaler to empty your lungs. Place the mouthpiece firmly in your mouth, creating a tight seal with your lips. Unlike MDIs, DPIs require a quick and deep inhalation through your mouth to pull the powdered medicine into your lungs. Once you have inhaled, remove the inhaler from your mouth and hold your breath for up to 10 seconds to allow the medicine to settle. Slowly exhale and, if prescribed, rinse your mouth with water and spit it out, especially if your medicine is a corticosteroid, to help prevent oral infections.
Caring for Your Inhaler
For Metered-Dose Inhalers, remove the metal canister from the plastic casing; never get the metal canister wet. Rinse the plastic mouthpiece and cap under warm running water for about 30 seconds, ensuring any buildup is cleared. After rinsing, shake off excess water and allow the plastic parts to air dry completely, ideally overnight, before reassembling. Cleaning should be done at least once a week, or more frequently if specified by your healthcare provider.
Dry Powder Inhalers, unlike MDIs, should never be washed with water because moisture can damage the powder medication. Instead, wipe the mouthpiece with a clean, dry cloth to remove any residue. Store all inhalers at room temperature, generally between 68°F to 77°F (20°C to 25°C), and away from direct sunlight, extreme temperatures, or humidity, as these conditions can affect medication stability and device function. Many inhalers include a dose counter to show how many doses remain, which helps in knowing when to get a refill. For inhalers without a counter, track the number of puffs taken to estimate when it will run out.
Addressing Usage Concerns
Users may encounter various issues when using their inhalers. If you do not feel or taste the medication after using a dry powder inhaler, it does not necessarily mean the dose was ineffective, as the particles are very small. For MDIs, if you do not feel a spray or taste medication, it could indicate an issue with technique, an empty inhaler, or a clogged device. If you cough immediately after using your inhaler, it might suggest you inhaled too quickly or that the medication irritated your throat; consult your healthcare provider if this persists.
An inhaler might be empty even if it still produces a spray, especially for MDIs, because the propellant can continue to be released after the medicine is depleted. Relying solely on shaking the inhaler or hearing a spray is not a reliable way to determine remaining doses for MDIs without a dose counter. If you miss a dose, take it as soon as you remember unless it is almost time for your next scheduled dose; do not double the dose. If your symptoms do not improve or worsen despite proper inhaler use, or if you frequently run out of medication, contact your doctor for guidance.