Using Your Inhaler

Proper inhaler technique is very important. Good technique assures that the medicine reaches the lungs. Poor technique results in depositing the medicine on the tongue and back of the throat rather than in the airways.

STEPS TO FOLLOW IF USING INHALER WITHOUT EXTENSION TUBE:

  1. Remove cap from inhaler.

  2. Shake inhaler for 5 seconds before each inhalation (breathing in).

  3. Position the inhaler so that the top of the canister faces up.

  4. Put your index finger on the top of the medication canister. Your thumb supports the bottom of the inhaler.

  5. Open your mouth.

  6. Hold the inhaler 1 to 2 inches away from your open mouth. This allows the medicine to slow down before the medicine enters the mouth.

  7. Exhale (breathe out) normally and as completely as possible.

  8. Press the canister down with the index finger to release the medication.

  9. At the same time as the canister is pressed, inhale deeply and slowly until the lungs are completely filled. This should take 4 to 6 seconds. Keep your tongue down and out of the way.

  10. Hold the medication in your lungs for up to 10 seconds (10 seconds is best). This helps the medicine get into the small airways of your lungs to work better.

  11. Breathe out slowly, through pursed lips. Whistling is an example of pursed lips.

  12. Wait at least 1 minute between puffs. Continue with the above steps until you have taken the number of puffs your caregiver has ordered.

  13. Replace cap on inhaler.

STEPS TO FOLLOW USING AN INHALER WITH AN EXTENSION (SPACER):

  1. Remove cap from inhaler.

  2. Shake inhaler for 5 seconds before each inhalation (breathing in).

  3. Your caregiver has asked you to use a spacer with your inhaler. A spacer is a plastic tube with a mouthpiece on one end and an opening that connects to the inhaler on the other end. A spacer helps you take the medicine better.

  4. Place the open end of the spacer onto the mouthpiece of the inhaler.

  5. Position the inhaler so that the top of the canister faces up and the spacer mouthpiece faces you.

  6. Put your index finger on the top of the medication canister. Your thumb supports the bottom of the inhaler and the spacer.

  7. Exhale (breathe out) normally and as completely as possible.

  8. Immediately after exhaling, place the spacer between your teeth and into your mouth. Close your mouth tightly around the spacer.

  9. Press the canister down with the index finger to release the medication.

  10. At the same time as the canister is pressed, inhale deeply and slowly until the lungs are completely filled. This should take 4 to 6 seconds. Keep your tongue down and out of the way.

  11. Hold the medication in your lungs for up to 10 seconds (10 seconds is best). This helps the medicine get into the small airways of your lungs to work better. Exhale.

  12. Repeat inhaling deeply through the spacer mouthpiece. Again hold that breath for up to 10 seconds (10 seconds is best). Exhale slowly. If it is difficult to take this second deep breath through the spacer, breathe normally several times through the spacer. Remove the spacer from your mouth.

  13. Wait at least 1 minute between puffs. Continue with the above steps until you have taken the number of puffs your caregiver has ordered.

  14. Remove spacer from the inhaler and place cap on inhaler.

If you are using different kinds of inhalers, use your quick relief medicine to open the airways 10 - 15 minutes before using a steroid. If you are unsure which inhalers to use and the order of using them, ask your caregiver, nurse, or respiratory therapist.

If you are using a steroid inhaler, rinse your mouth with water after your last puff and then spit out the water. Do not swallow the water.

Avoid the following:

  • Inhaling before or after starting the spray of medicine. It takes practice to coordinate your breathing with triggering the spray.

  • Inhaling through the nose (rather than the mouth) when triggering the spray.

HOW TO DETERMINE IF YOUR INHALER IS FULL OR NEARLY EMPTY:

  • Determine when an inhaler is empty. You cannot know when an inhaler is empty by shaking it. A few inhalers are now being made with dose counters. Ask your caregiver for a prescription that has a dose counter if you feel you need that extra help.

  • If your inhaler does not have a counter, check the number of doses in the inhaler before you use it. The canister or box will list the number of doses in the canister. Divide the total number of doses in the canister by the number you will use each day to find how many days the canister will last. (For example, if your canister has 200 doses and you take 2 puffs, 4 times each day, which is 8 puffs a day. Dividing 200 by 8 equals 25. The canister should last 25 days.) Using a calendar, count forward that many days to see when your inhaler will run out. Write the refill date on a calendar or your canister.

  • Remember, if you need to take extra doses, the inhaler will empty sooner than you figured. Be sure you have a refill before your canister runs out. Refill your inhaler 7 to 10 days before it runs out.

HOME CARE INSTRUCTIONS

  • Do not use the inhaler more than your caregiver tells you. If you are still wheezing and are feeling tightness in your chest, call your caregiver.

  • Keep an adequate supply of medication. This includes making sure the medicine is not expired, and you have a spare inhaler.

  • Follow your caregiver or inhaler insert directions for cleaning the inhaler and spacer.

SEEK MEDICAL CARE IF:

  • Symptoms are only partially relieved with your inhaler.

  • You are having trouble using your inhaler.

  • You experience some increase in phlegm.

  • You develop a fever of 100.5° F (38.1° C).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You feel little or no relief with your inhalers. You are still wheezing and are feeling shortness of breath and/or tightness in your chest.

  • You have side effects such as dizziness, headaches or fast heart rate.

  • You have chills, fever, night sweats or an oral temperature above 102° F (38.9° C).

  • Phlegm production increases a lot, or there is blood in the phlegm.

MAKE SURE YOU:

  • Understand these instructions.

  • Will watch your condition.

  • Will get help right away if you are not doing well or get worse.