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A Guide to Asthma Inhalers

If you have asthma, you are probably very familiar with asthma inhalers. The devices are the most effective way of getting medication to the lungs, but inhalers cannot do the job if they are not used correctly.

Hand-held asthma inhalers are used to provide quick relief from asthma symptoms by delivering medication directly to the airways, with few side effects.  Asthma medications may also be administered orally or intravenously.

There are three types of inhalers, including metered dose inhalers (MDIs), dry powder inhalers (DPIs), and nebulizers.  Each has a different delivery system.

1.) Metered Dose Inhalers - Metered dose inhalers are small, aerosol canisters, often used with a spacer.  Medication is sprayed into the mouth by means of a chemical propellant and breathed in by the patient.  The spacer, a tube that attaches to the MDI, holds the medication until it can be
breathed in, and can make the entire process easier and more efficient.  Patients should consult with their pharmacists on whether their inhaler can be used with a spacer.

2.) Dry Powder Inhalers - Dry powder inhalers require patients to inhale quickly and deeply which can make them difficult for asthma sufferers to use, especially when symptoms are present.  The techniques for using DPIs also vary, so be sure to read instructions carefully before starting medication.

3.) Nebulizers - Nebulizers allow patients to breathe normally while taking medication because the drugs are delivered through a mouthpiece or mask. For that reason, they are often used to administer asthma drugs to children or people unable to use other types of inhalers.

Asthma inhalers contain two types of drugs--anti-inflammatories and bronchodilators. The anti-inflammatories, which include corticosteroids and mast cell stabilizers, help patients gain control of their symptoms by reducing swelling and mucus production in the airways.  Short- and long-acting bronchodilators are used to control wheezing, coughing, and shortness of breath.  Some asthma inhalers feature a combination of both types of drugs.

To use an MDI with a spacer - remove the caps from both the canister and the spacer. Shake the canister then insert it into the end of the spacer opposite the mouthpiece. Exhale completely before putting the mouthpiece between the teeth and sealing it tightly with the lips.
Press the canister once to release the medication then breathe in slowly and completely. Hold the breath for at least ten seconds then remove the spacer and exhale slowly.  Wait one minute between doses.

To use an MDI without a spacer - remove the cap from the inhaler and shake well. Hold the inhaler between the index finger and thumb, with index finger on top of the canister and the thumb under the plastic mouthpiece.  Sit or stand up straight, tilt the head back a bit, and exhale completely. The mouthpiece can be placed between the teeth, with lips sealed around it, or the inhaler can be held about two inches in front of the mouth. Breathe in and out once.  On the next inhale, press the canister down to release the medication and breathe in slowly and deeply for three to five seconds.  Hold the breath for at least ten seconds.  Wait one minute before taking a second dose.

Mask inhalers are most often used with children, but they do come in adult sizes as well. To use an asthma inhaler with a mask spacer remove the cap from the inhaler and shake it well.  Secure the MDI in the soft ring at the end of the spacer opposite the mask. The mask should be placed over the nose and mouth, creating a good seal.  Spray a puff of medication into the spacer and have the patient take six breaths. Wait one minute between doses. Wash the face with mild soap and water after the treatment is completed.

Always gargle and rinse out the mouth with water or mouthwash after using inhalers that contain steroids.

It may require a little practice but most people can master the proper use of an inhaler without much trouble and be on their way to breathing easier.

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