Metered-Dose Inhaler Instructions
What is an MDI? (Metered-Dose Inhaler)
The MDI, often simply called an inhaler, is a small, pressurized can that contains aerosol medicine to be inhaled. Many asthma medications are taken with an inhaler. MDI's are also frequently used by people who suffer other respiratory ailments, such as emphysema, chronic lung disease, and bronchitis.
What is a spacer?
Spacers are tubes that attach to the inhaler and act as a reservoir or holding chamber. They serve to hold the medication that is sprayed by the inhaler. This makes it easier to use your inhaler and helps to ensure that you get more of the medication into your lungs instead of just into your mouth or the air. With proper use, a spacer can make an inhaler 20% more effective in delivering medicine.
How to use an MDI with a spacer (Aerochamber)
1. Ensure that the metal canister of the inhaler is firmly inserted into the plastic cover shell.
2. Remove the plastic caps from the inhaler and Aerochamber.
3. Shake the inhaler vigorously.
4. Insert the plastic mouthpiece of the inhaler into the rubber ring of the Aerochamber.
5. Breath out normally.
6. Insert the mouthpiece of the Aerochamber into your mouth and seal lips around it.
7. Press down firmly on the inhaler to release the medication as you start to breathe in.
8. Take a slow deep breath in (until maximum inspiration is reached) and hold it for
5-10 seconds. If you hear a whistling sound, you are breathing in too fast.
9. Remove the Aerochamber from your mouth and breath out slowly.
10. If more than one puff is prescribed, repeat the process. (do not spray more than one puff
at a time into the spacer)
11. Rinse out your mouth after using Flovent, Beclomethasone, Vanceril, or other
inhaled steroids.
12. Remove the inhaler from the spacer and replace the caps.
MDI Spacer
How to clean your inhaler and spacer
Clean the mouthpiece and cap at least once a week by rinsing in warm water. Make sure to shake off any excess water, and let them air-dry overnight. When dry, store in a clean, sealed plastic bag to keep out dust and debris.
When does an inhaler need to be replaced?
It is important that you understand how long your inhaler will last, as it is not always easy to notice when you are running low on medication. Your inhaler is made to deliver the prescribed amount of medication until it is empty. You can calculate how long an inhaler will last using the following method:
- Check the inhaler box to see how many "metered inhalations" or puffs it contains.
- Next, figure out how many puffs you will take per day (e.g., 2 puffs, 4 times a day = 8 puffs a day).
- Divide this number into the number of puffs contained in the canister. That will tell you how many days the inhaler canister will last. Make sure to count forward and mark the day on your calendar that the inhaler will need to be replaced to make sure you refill your prescription beforehand.
Example:
Inhaler canister contains 200 puffs.
take 2 puffs, 4 times a day (2 x 4) = 8 puffs a day.
divided by 8 = 25. The inhaler canister will last 25 days. In this example you would need to make sure you have a replacement canister on hand 25 days from the day you first receive the inhaler.
You can estimate how much medicine is left in your MDI by trying the following:
the MDI into water as shown below.
“Float Test”
An electronic device that will keep track of remaining doses and a daily history
Available at www.thedoser.com
Medications given by Inhaler
Bronchodilators are commonly used medications that immediately relax the muscle of airways that are in spasm, meaning they open up the airways. Generally they provide prompt relief. Side effects can include:
- Tremors
- Fast or pounding heartbeat
- Nervousness
- Dizziness
When taken as directed, these reliever medications do not cause long-term side effects.
Short-Acting Beta2-Agonists
- Albuterol - Inhaler (Albuterol, Proventil®, Proventil HFA®, Ventolin®, Ventolin Rotacaps®)
- Bitolterol - Inhaler and Nebulizer (Tornalate®)
- Pirbuterol - Inhaler (Maxair®, Maxair Autohaler®)
- Terbutaline - Inhaler (Brethaire®)
Anticholinergic Bronchodilators
One example of an anticholinergic bronchodilator is Atrovent (ipratropium bromide)
- It relaxes airway muscle by blocking the nerves that cause constriction of the airways.
- It is sometimes used in combination with a short-acting beta2-bronchodilator.
- It should be used with caution if you have glaucoma. Accidental spraying of the mist in the eyes can worsen the eye problem.
- It is not fast-acting enough to be used as "front-line" reliever medicines.
- Common side effects include dry mouth, dry throat, dry nose, and headache.
Long-Acting Bronchodilators
Combivent® is expected to maximize the response to treatment in patients with chronic obstructive pulmonary disease (COPD) by reducing bronchospasm through two distinctly different mechanisms, anticholinergic (parasympatholytic) and sympathomimetic.
Simultaneous administration of both an anticholinergic (ipratropium bromide) and a beta2-sympathomimetic (albuterol sulfate) is designed to benefit the patient by producing a greater bronchodilator effect than when either drug is utilized alone at its recommended dosage.
Serevent (Salmeterol)
This bronchodilator is a long-term control medication that takes 10 to 20 minutes to start working. It is not to be used as a rescue medication. The medicine works for about 12 hours after the dose is taken.
The most common side effects are jitteriness and an increased heart rate
Corticosteroids
Anti-inflammatory medications:
Common side effects:
- Hoarse voice
- Thrush (a yeast infection of the mouth and throat)
Rinse the mouth thoroughly after each treatment and use a spacer device to decrease the chance of side effects.
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