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Inhalers

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How should I use an inhaler?

There are different types of inhalers – metered dose inhaler (MDI), breath activated inhaler and dry powder inhaler. Follow these instructions below for the type of inhaler prescribed.

There are always new inhalers being developed. If your inhaler is not listed here, follow the package insert regarding how to use the inhaler. 

If you use more than one kind of inhaled medicine at a time, the reliever medicine (such as albuterol) should be taken first to open the airways. This helps the other medicine(s) go deeper into the lungs, so they will work better. 

Metered dose inhaler (MDI)

A metered dose inhaler is used with a spacing device, also called a spacer or holding chamber. It helps the mist reach deeply into the lungs. If you are not able to hold your breath for 10 seconds, you may need to use a spacer with a mask.

Prepare the inhaler:

  1. Remove caps from the inhaler and the spacer.
  2. Shake the inhaler well (about 5 seconds) to mix the medicine and propellant.
  3. Insert the inhaler into the spacer.

Using a spacer without a mask

  1. Breathe out slowly all the way.
  2. Put the mouthpiece into your mouth, over your tongue, between your teeth and close your lips around it.
  3. Press down on the inhaler as you start to breathe in slowly and deeply through your mouth.
  4. Hold your breath for 10 seconds to let the medicine stay in the lungs and airways.
  5. Exhale slowly.
  6. Wait about 1 minute between puffs of the rescue medicine. There is no need to wait between puffs of the controller medicine.

Using a spacer with a mask

  1. Put the mask over nose and mouth.
  2. Press down on the inhaler.
  3. Keep the mask sealed around the nose and mouth and breathe in and out for 3 to 5 breaths.
  4. Rinse your mouth with water and spit it out after using a steroid (controller) inhaler.

How do I know when an MDI is empty?

Don't Run Out

Inhalers have counter windows so you know how many doses are left. If it says 0, throw it away and get a new inhaler.

How do I care for the spacer?

Follow the directions on the package to clean your spacer.

Dry powder inhaler: Diskus

  1. Hold the Diskus in one hand. Push the thumb grip back as far as it will go, until the mouthpiece appears and snaps into place.
  2. Hold the Diskus level, with the mouthpiece towards you. Slide the lever all the way until it clicks.
  3. Turn your head away from the Diskus and breathe out completely.
  4. Put the mouthpiece between your lips. Breathe in steadily and deeply.
  5. Remove the Diskus from your mouth.
  6. Hold your breath for 10 seconds. Then breathe out slowly.
  7. Close the Diskus by sliding the thumbgrip back as far as it will go.
  8. Rinse your mouth and spit without swallowing.

How do I know when the Diskus is empty?

The dose indicator on top tells how many doses are left. When the number is "0", throw the Diskus away and use a new one.

Dry powder inhaler: Flexhaler

Flexhaler

Priming the Flexhaler

A new Flexhaler should be primed once before its first use. Follow these steps:

  1. Turn the cover and lift it off.
  2. Hold the Flexhaler upright, with mouthpiece up.
  3. Twist the brown grip fully to the right and back again to the left.
  4. Repeat step 3. Now it is ready for use.

Using the Flexhaler

  1. Twist the cover and lift it off. Hold the Flexhaler upright (mouthpiece up).
  2. Twist the brown grip to the right as far as it will go, then back to the left until it clicks.
  3. Turn your head away from the Flexhaler and breathe out completely. (Note: Do not shake or exhale into it.)
  4. Put the mouthpiece between your lips and inhale deeply and forcefully to fill your lungs.
  5. Remove the Flexhaler from your mouth.
  6. Hold your breath for 10 seconds. Then breathe out slowly.
  7. Repeat steps 2 through 6, if a second puff is prescribed.
  8. When finished, replace the cover and twist shut.
  9. Rinse your mouth and spit without swallowing.

How do I know if a Flexhaler is empty?

The inhaler is empty when the "0" on the red background reaches the middle of the window. Throw the inhaler away and start a new one.

Dry powder inhaler: Ellipta

  1. Open the cover of the inhaler by sliding down to expose the mouthpiece until you hear a click.  The counter will countdown by one number.  Breathe out fully while holding the inhaler away from your mouth.
  2. Put the mouthpiece firmly between your lips and take one long steady breath in through your mouth.
  3. Hold your breath for about 10 seconds.
  4. Be careful not to cover the vent with your fingers when inhaling.
  5. Remove the inhaler from your mouth.
  6. Close the inhaler by sliding the cover up and over the mouthpiece as far as it will go.

Dry powder inhaler: Respiclick

  1. Open the cap all the way back until you hear a “click”.
  2. Breathe out through your mouth, not into the inhaler mouthpiece.
  3. Put the mouthpiece in your mouth and close your lips around it.
  4. Breathe in deeply.
  5. Hold your breath for about 10 seconds.
  6. Remove the inhaler from your mouth and close the cap.
  7. Repeat steps 1 through 6 if another dose is needed.

How do I know if Respiclick is empty?

The inhaler is empty when the “0” on the red background reaches the middle of the window. Throw the inhaler away and start a new one. 

Redihaler (Breath activated; no spacer required)

  1. Open the cap.
  2. Hold the inhaler upright.
  3. Breathe out but not into the mouthpiece.
  4. Place the mouthpiece between your lips so you can form a good seal.
  5. Breathe in deeply to release the medicine. You will hear a “click” when the medicine comes out so keep breathing in.
  6. Hold your breath for 10 seconds.
  7. Breathe out slowly away from the inhaler.
  8. Close the cap.
  9. If a second dose is needed, repeat steps 1-8.

How do I know if Redihaler is empty?

The inhaler is empty when the dose counter shows “0”.  Throw the inhaler away and start a new one.

Questions?

This sheet is not specific to your child, but provides general information. If you have any questions, please call your doctor.

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This page is not specific to your child, but provides general information on the topic above. If you have any questions, please call your clinic. For more reading material about this and other health topics, please call or visit Children's Family Resource Center library, or visit www.childrensmn.org/educationmaterials.

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