Inhaler Technique

Inhalers are commonly prescribed for patients with asthma and chronic obstructive pulmonary disease (COPD) as they are very effective at delivering the medication straight to the lungs where it is needed.

Using your inhalers correctly is an important part of asthma or COPD treatment. You should be shown how to use inhalers properly by a healthcare professional when they are first prescribed.

You may occasionally experience problems using your inhalers, especially if it has been a while since you were shown the correct technique. This is very common and your healthcare professional can help you improve your inhaler technique.

Why is inhaler technique important?
· It allows the correct dose of medication to reach your lungs.

· It gives you better control of your condition.

 

Asthma UK has a way of easily searching for your inhaler.

 

 

https://www.asthma.org.uk/advice/inhaler-videos/

https://www.asthma.org.uk/advice/inhaler-videos/

 

Click on the leicester ccg for videos and leaflets.

Click on the Leicester link to see videos the leaflets are linked below in orange

Asthma Inhaler Technique Videos

How to use your Accuhaler inhaler leaflet

How to use your Autohaler inhaler leaflet

How to use your Easi-breathe inhaler leaflet

How to use your Easyhaler inhaler leaflet

How to use your Ellipta inhaler leaflet

How to use your Genuair inhaler leaflet

How to use your metered dose inhaler leaflet

How to use your metered dose inhaler with large volume spacer device leaflet

How to use your metered dose inhaler with small volume spacer device leaflet

How to use your NEXThaler inhaler leaflet

How to use your Respimat inhaler A4 leaflet How to use your Spiriva HandiHaler inhaler leaflet

How to use your Spiromax inhaler leaflet 2.0

How to use your Turbohaler inhaler leaflet

COPD

Tiotropum (COPD)

https://www.spiriva.com/copd/starting-spiriva/how-to-use-spiriva-handihaler

http://products.tevauk.com/p/tiotropium-bromide-668 -braltus

 

https://gskpro.com/en-mt/therapy-areas/respiratory/gsk-inhalers-copd/ellipta-how-to-use/

 

Chiesl Products

e.g. trimbow

Device Videos

Trimbow® How to use with a spacer - Video play button

Types of active ingredients in inhalers ( These last three are often now days mixed in different combinations)

Short acting beta-agonists that open up the wind-pipe. They are for short term relief. If they are frequently needed or there are symptoms they are not sufficient or the technique is poor.e.g. ventolin

Steroid inhalers component to damp down the soreness and regular usage reduces the soreness and irritibility of the airways reducing the  triggering of asthma. e.g. clenil

Long acting beta-agonists that open up the airways for longer ( when steroid inhalers do not control asthma) e.g. salmeterol, ingredient in fostair,seretide. These rely on regular use

Antimuscarinic drugs (generally used for COPD) such as tioptopium which relax the muscles in the airways which would normally close it up. e.g. tiotropium, braltus. These rely on daily use.

All inhalers

With all inhalers you should check that there is no foreign body in the mouthpeice to pevent choking on anything unexpected.

 

Sit upright to let you take a good breath in.

All inhalers require you to empty your lungs before you take your inhaler to give room for the medicine.

All inhalers require you to hold the medicine in your lungs to work. Ideally upto 10 seconds.

 

Use the cover to protect the mouth peice when not in use.

Powdered inhalers versus Pressurised inhalers

The big differences are –

The pressurised inhalers need energy to give heat to be used to change the liquid to a gas. Hence shaking it is important and giving time between puffs (so that the inhaler can reheat with heat from the surroundings). The gas comes out over 3-5 seconds nad therefore you should take a longer breath in than with the powdered inhalers. This is why multipuffs (Several puffs in one go) is a bad idea.

The coordination of your breathing needs to be ok as you need to press the inhaler to release the gas just after you start breathing in and continue to breath in slow and steady for upto 5 seconds. Ifyou cannot manage this spacers are also used.

 

The powdered inhalers rely on energy from your breath to break up the powder and hence the breath in needs to be sharper and quicker.

The timing is not so important as you are effectively sucking the powder into your lungs. For some inhalers you need to breath in quite hard.

 

 

mdi

Checklist for metered dose inhaler use

1 Stand or sit upright when using your inhaler.
2 Remove the inhaler cap.
3 Hold the inhaler upright and shake 4 or 5 times.
4 Breathe out fully.
5 Place the mouthpiece between your teeth without biting and form a good seal around it with your lips.
6 Breathe in through your mouth and press the canister down at the same time to release a puff of medicine.
7 Continue to breathe in slowly and deeply for 3-5 seconds.
8 Hold your breath and take the inhaler from your mouth.
9 Continue to hold your breath for 10 seconds or as long as is comfortable. Breathe out slowly.
10 If your doctor has told you to take two puffs, wait 30 seconds then repeat steps 3 to 9.
11 Replace the cap straight away to keep out dust.

Common problems

Common mistakes that people make with metered dose inhalers include:

  • Not standing, sitting or holding the inhaler upright.
  • Not shaking the inhaler before using it.
  • Inhaling too sharply, at the wrong time or not deeply enough.
  • Not holding your breath long enough after breathing in the contents.
  • Taking several puffs without waiting between them.
  • It can be difficult to tell when the inhaler is empty.

 

Useful tips

  • Practice in a mirror, if you see a ‘mist’ from the top of the inhaler or the sides of your mouth you should start again.
  • If your inhaler contains a corticosteroid rinse your mouth out with water after your dose.
  • A spacer device used with your inhaler could help with any co-ordination problem, help the medication reach the lungs and reduce any side effects.
  • Always read the patient leaflet provided with your inhaler for any specific instructions.
  • Speak to your nurse or pharmacist if you experience problems using your inhaler.
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