How to Use an Inhaler
One or more of the drugs needed to control your asthma symptoms will probably come in a device called a metered-dose inhaler. Drugs that are administered this way provide excellent and rapid control over asthma symptoms because they go directly to the source of the trouble - the airways. They are also less likely to cause side effects than medicines taken as tablets or liquids. Although it takes a little time and effort to learn how to use an inhaler properly, you will be rewarded by increased control over your troublesome asthma symptoms.
Before you start
These are general instructions for using inhalers. Your doctor will give you specific instructions for your particular medicine; follow these instructions carefully. Before you leave the doctor's office, be sure you understand all the information the doctor has given you about your inhaler. Wrong use of the inhaler could result in either too little or too much medication reaching your lungs.
How to use an inhaler
Give the canister one press before starting just to get used to how it works.
With the inhaler in an upright position and the mouthpiece about two inches from your mouth, place your index finger on the canister and your thumb at the bend of the inhaler. Breathe out completely in a normal manner before proceeding (see the first illustration below).
Tilt your head back, almost like a sword-swallower.
Breathe in slowly and deeply. At the same time, press down on the top of the canister to release the medication.
Hold your breath for 10 seconds, and then breathe out slowly.
Using a spacer
If you have trouble inhaling at the same time you press down on the canister, your doctor may give you a device called a spacer, which makes the mouthpiece longer (see the next illustration). Place the end of the spacer loosely between your teeth and seal your lips around it. With your head back, press the canister and inhale slowly and deeply. (It is not necessary to press the canister at exactly the same time as you inhale when using a spacer.) Hold your breath for 10 seconds and breathe out slowly.
Hints for successful inhaler use
It you are not using a spacer, practice inhaling and pressing the canister at the same time. This helps the medication get deep down into the lungs, so it is worth practicing until you feel comfortable with the technique.
If you see a fine mist escaping from your nose or mouth, you are not using the inhaler correctly. All of the mist should go to your lungs. See your physician or a member of his staff as soon as possible for another lesson about inhaler use if this occurs.
If your physician instructs you to take two inhalations at a time, try to wait 3-5 minutes between inhalations. The second inhalation may be more effective if the first one has time to open the air passages. Also, if you are taking more than one inhaled medication at the same time, try to wait several minutes after finishing the first one before starting the second.
Rinse your inhaler several times a week with warm water.
Do not take more inhalations (or use the inhaler more often) than prescribed by your doctor. Some medication will enter your bloodstream when you use your inhaler, and if you take too many inhalations or use it too often, you may experience unpleasant side effects, such as a rapid heartbeat. The medication may also irritate your air passages if you use it too often, and you will not receive the benefits of the medication.
Your doctor will tell you what to do if you experience a severe asthma attack. If you cannot bring the attack under control with the number of inhalations you were told to take during a severe attack, seek medical help immediately. DO NOT CONTINUE TO USE THE INHALER UNDER THESE CIRCUMSTANCES UNLESS INSTRUCTED TO DO SO BY YOUR PHYSICIAN.
If your inhaler medication becomes less effective or seems to wear off more quickly than it did when you first started using it, consult your physician. Do not attempt to change the dosages yourself.
Some inhaled medications for asthma are available in drugstores without a prescription. Do not take these medications if you are already using a prescription inhaler. If your physician has not prescribed an inhaler, check with your doctor before using a nonprescription inhaler.
Brad Kney, MD