How to properly administer your inhaler in order to take advantage of its benefits
A couple of years ago, I had pneumonia. After going to the doctor and getting a slew of antibiotics and steroids, my doctor also gave me a prescription for an inhaler of Albuterol (in health care terms metered dose inhaler). I headed over to the pharmacy, went to the drive up window, and spoke with the pharmacy technician to get my medications. Keep in mind, this pharmacy technician had no idea that I was a Respiratory Therapist or that I had any knowledge of how to take my medications properly. She quickly asked me prior to handing me my prescriptions, “Do you have any questions regarding your medications or how to take them?” Feeling as bad as I did, I answered, “No. I have no questions.” As I was driving home, it dawned on me… Now I get it! You see, for several years prior to my own bout of pneumonia, I didn’t quite understand the reason why a high percentage of patients that I see have gotten no instruction on how to take their inhalers properly. Yes…. I am aware there are instructions located inside the packaging of the medication but seriously…. Have any of you tried to read it? The print size is microscopic.
The effectiveness of your inhaler largely depends on how well you take it. There are some fundamental things that you must do in order to get the medication directly to the airways. Many of the inhaled medications you take must get down into your smaller airways for you to get any benefit from taking them. So with that being said, here’s how I instruct my patients on how to take their inhalers.
1. Start off with a large cleansing breath to open any airways that you haven’t been using in a resting state.
2. Shake your inhaler well to mix its contents. If you haven’t used your inhaler in months, sometimes they recommend dispensing a puff (or wasting a puff) in the air to prime the inhaler and blow out any dust that might have collected in the actuator. I’m not going to insist on this because I realized that many of my patients are on fixed incomes and that medications are expensive and for many of my patients… every puff counts.
3. Take another deep breath in and blow out slowly.
4. Right before you take your next breath in, hold the inhaler up to your mouth and form a seal with your lips around the mouth piece.
5. Press down on the actuator and breathe in AT THE SAME TIME with a medium speed.
6. Remove the inhaler from your mouth and hold your breath for at least 7-10 seconds.
7. When you are ready, slowly blow out
8. DO NOT immediately administer another puff if prescribed. Wait a FULL 1-2 minutes before administering next puff.
*If you are administering a steroid inhaler – make sure you rinse your mouth thoroughly in order to prevent thrush
*Spacers are often times prescribed with your meter dose inhalers. These little beauties were invented to assist the pulmonary patient in getting a quality treatment from their inhalers. The nice thing about these devices is that it doesn’t require the patient to have the coordination to breathe in and push down on the actuator simultaneously. To use a spacer, attach the device to the inhaler prior to using it. Follow the directions as stated above with the exception that you press down on the actuator and then immediately breathe in the medication with a nice slow deep breath. Many spacers will “hum” if the inhaled breath was too fast.
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