Using Medicine

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Using an inhaler seems simple, but most patients do not use it the right way. When you use your inhaler the wrong way, less medicine gets to your lungs.

For the next 2 weeks, read these steps aloud as you do them or ask someone to read them to you. Ask your doctor, pharmacist or nurse to check how well you are using your inhaler.

Use your inhaler in one of the three ways pictured below (A or B are the best, but C can be used if you have trouble with A and B)

Steps for Using Your Inhaler

Getting Ready

• Take off the cap and shake the inhaler
• Breath out all the way
• Hold you inhaler the way your doctor said (A, B, or C below).

Breathe in slowly

• As you start breathing in slowly through your mouth, press down on the inhaler one time (If you use a holding chamber, first press down on the inhaler. Within 5 seconds, begin to breathe in slowly.
• Keep breathing in slowly, as deeply as you can.

Hold your breath

• Hold your breath as you count to 10 slowly, if you can.
• Wait about 1 minute between puffs.

A. Hold inhaler 1 to 2 inches in front of your mouth 
(about the width of two fingers)

B. Use a spacer/ holding chamber. 
These come in many shapes and can be useful to any patient.

C. Put the inhaler in your mouth. 
Do not use for steroids.

Clean Your Inhaler as Needed

Look at the hole where the medicine sprays out from your inhaler. If you see "powder" in or around the hole, clean the inhaler. Remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and cap in warm water. Let them dry overnight. In the morning, put the canister back inside. Put the cap on.

Additional Tips for Using Inhalers

1. There are three types of medication that can be delivered with a metered dose inhaler:

   • Bronchodilators- medications that relax the muscles around the bronchial tubes and make breathing easier. These are used for immediate relief of symptoms.

   • Corticosteroids- medications that decrease inflammation and swelling in the airways. They do not provide relief immediately but may help reduce the frequency and severity of acute attacks, if taken on a regular basis.

   • Cromolyn- medication that reduces inflammation and reactions in the airways. It does not provide relief immediately but may help reduce the frequency and severity of acute attacks, if taken on a regular basis.

2. Rinse mouth with water or mouth wash after using corticosteroid medication to prevent hoarseness and fungal infections in the mouth and throat.

3. If you are taking more than one inhaled medication, it is important to take them in the correct order. Bronchodilating medications are usually taken first to open the airways and allow other types of medications to be more effectively inhaled into the lungs. Corticosteroids and cromolyn are inhaled after bronchodilating drugs.

4. Avoid the use of over-the-counter inhalers. Most of these contain epinephrine, which is effective for only a short time and may cause rebound bronchospasm (making it more difficult to breathe).

5. Take only the recommended number of puffs prescribed by your provider; over-use or incorrect use can be dangerous.

6. Notify your doctor if any of the following occur:
   • You do not get relief from your metered dose inhaler
   • You have increasing shortness of breath despite use of inhalers
   • You are experiencing weakness, increased heart rate, shakiness, insomnia, nervousness, headaches, nausea or vomiting