If you are one of the nearly 24 million Americans who have a breathing disorder such as asthma or chronic bronchitis, your health care provider may prescribe a variety of medications including inhalers to help keep your symptoms under control. A metered-dose inhaler (MDI) provides a measured dose of medication that you take by inhaling it directly into your lungs.
When you have an asthma attack, it is critical for your medication to act quickly to relieve symptoms so you can breathe more easily. Inhaled medication goes directly to the lungs so it can act more quickly than medication taken by mouth that must travel through the bloodstream before it can begin to work. MDIs can be very effective at delivering the correct dose quickly if they are used correctly. But if you don’t use the inhaler correctly, you may not get the full dose of medication which can allow asthma symptoms to get worse instead of better.
Most MDIs have a chamber such as a metal cylinder that holds a mixture of medication and propellant. The propellant turns the medication into a fine mist which is forced out through the mouthpiece when you push down on the cylinder. Another type of inhaler called a diskus dispenses the medication as a powder. Be sure you know which type of inhaler you have so you can use it correctly.
Try these tips to get the most out of your measured-dose inhaler:
1. Remove the cover from the plastic mouthpiece.
2. Hold the inhaler upright and shake it to mix the propellant and medicine.
3. Position the inhaler. Experts disagree on the best way to use MDI inhalers. Some recommend that you hold the inhaler in front of your mouth but not inside your mouth. In this case the mouthpiece should be 1 to 2 inches away from your lips, which is about the width of two fingers. Others recommend placing the mouthpiece inside the mouth and closing your lips around it. Follow your doctor’s instructions for this step.
4. Exhale fully.
5. Press down on the silver canister inside the inhaler to spray the medication toward your mouth and at the same time take as deep a breath as you can through your mouth. Breathe in slowly rather than inhaling in a quick puff.
6. Hold your breath for 5 to 10 seconds if you are able to do so. This step is very important to allow the medicine to sit in your lungs for several seconds before you breathe out.
7. Exhale slowly.
8. If your doctor instructed you to take 2 puffs, repeat steps 1 through 7. If your inhaler contains a fast-acting bronchodilator as a rescue medicine, you should wait 1 minute between puffs. If your inhaler contains a controller medicine, you can take the second puff right away unless your doctor gives you other instructions.
9. If your inhaler contains a steroid, you may be instructed to rinse your mouth or brush your teeth immediately after using the inhaler. Some medications can stick to the tissue in the mouth and cause problems including the fungal infection thrush.
It is important to get the timing right between spraying the inhaler and breathing in. If you have trouble with this, talk to your doctor about getting a spacer for your inhaler. A spacer is a plastic tube that fits between the inhaler mouthpiece and your mouth. When you spray the inhaler, the mist is caught in the spacer which gives you a longer window of opportunity to inhale the medicine into your lungs.
Be sure to take care of your inhaler to keep it working at full strength. Follow the directions on the label to clean your inhaler so it doesn’t become clogged and stop dispensing the correct dose of medication. Also be sure to track how many puffs you have used so you’ll know when to refill your prescription. And take your inhaler with you when you visit your health care provider so you can demonstrate the method you are using to make sure you are getting the most out of your inhaler.
Reviewed July 14, 2011
by Michele Blacksberg R.N.
Edited by Alison Stanton