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Using an Inhaler and Nebulizer inhalercover.pdf 1 8/27/18 7:32 AM Using an Inhaler and Nebulizer C M Y CM MY CY CMY K Using an Inhaler and Nebulizer Inhalers An inhaler is a handheld device. It delivers medication directly into your airways. Inhalers are commonly used to treat problems that affect your ability to breathe. Your health care provider may recommend that you use an inhaler if you have: • Asthma. • Chronic obstructive pulmonary disease. • Other ongoing respiratory problems. The asthma medications delivered by the inhalers include: • Bronchodilators. • Steroids. • Combination of bronchodilators and steroids. Bronchodilators cause small airways in the lungs to open up. Steroids are used to relieve swelling and inflammation. Some inhalers are meant for limited use during an emergency situation. Others are used daily to prevent breathing problems. Using the right amount of medication is important in the treatment and prevention of ongoing respiratory problems. Medications can also decrease the sensitivity of the lungs to allergens. Inhalers are commonly used to deliver these medications directly into the airways. Inhaled medicine relieves symptoms faster than the same medicine given in pill form. Using an Inhaler and Nebulizer 1 Fewer side effects happen when medicine is delivered by an inhaler instead of taken in pill form. That’s because medicine from an inhaler goes directly into the airways. Very little medicine ends up in the bloodstream. Inhalers come in many different forms. The most commonly used inhalers are: • Metered dose inhalers. • Metered dose inhalers with a spacer. • Dry powder inhalers. A metered dose inhaler, or MDI, is a small aerosol canister that holds medicine. A mouthpiece is attached to the canister. The inhaler is small enough to fit inside a pocket. Some MDIs release the medicine when you push the canister into the mouth piece. Other MDIs release it when you inhale. A metered dose inhaler with a spacer is similar to a regular MDI. The main difference is that it holds the medicine in a special compartment, called a spacer, after it is released. An inhaler with a spacer is larger than a regular MDI. A spacer makes it easier to inhale the medicine more slowly. Inhaling slowly increases the amount of medicine that reaches your lungs. It prevents medicine from sticking to the back of your throat. Some MDIs come with a built-in spacer. Others require you to attach the spacer yourself. A dry powder inhaler, or DPI, does not use aerosol to push the medicine. Instead, you get the medicine by taking a fast, deep breath. DPIs are either shaped like a tube or disk. They may have a removable cap or cover. They may contain multiple doses of medication or a single dose. The following sections provide general instructions for using each type of inhaler. Your health care provider may also give you instructions. 2 Using an Inhaler and Nebulizer Using a Metered Dose Inhaler A metered dose inhaler usually has 3 parts: • A tube-shaped canister of medicine. • A mouth piece. • A cap that covers the mouthpiece. To prepare the inhaler: Metered Dose Inhaler 1. Take the cap off of the inhaler. 2. Shake the inhaler to mix the medicine. 3. Prime the inhaler. Release one or more sprays if you are using it for the first time or have not used it for more than 7 days. 4. Breathe out slowly and steadily to empty your lungs of air. Using an Inhaler and Nebulizer 3 To take the medicine from the inhaler: 5. Put the mouthpiece close to your open mouth or close your lips tightly around the mouthpiece. 6. Keep your chin up. 7. Begin to slowly breathe in through your mouth. 8. Spray 1 puff by pressing down on the inhaler. 9. Keep breathing in slowly. Breathe in as deeply as you can. 10. To get the medicine into your airway: 11. Take the inhaler out of your mouth if you closed your lips around it. 12. Hold your breath and count to 10 or more. 13. Slowly breathe out through your mouth while puckering your lips. 4 Using an Inhaler and Nebulizer Depending on the dose your health care provider prescribed, you may have to take more than one puff of medicine. If this is the case, repeat steps 5-12. For inhaled quick-relief medicine (like albuterol), wait about 1 minute between puffs. Rinse your mouth with after using your inhaler. Do not swallow the water. Instead, gargle and spit it out. A metered dose inhaler with a spacer usually has 4 parts: • A tube-shaped canister of medicine. • A cap that covers the mouthpiece. • A mouthpiece. • A spacer, which may be removable. Metered Dose Inhaler with Spacer To prepare the inhaler: 1. Take the cap off the inhaler and spacer. 2. Shake the inhaler to mix the medicine. 3. Attach the spacer to the inhaler if it is not already attached. 4. Prime the inhaler. Release one or more sprays if you are using it for the first time or have not used it for more than 7 days. 5. Breathe out slowly and steadily to empty your lungs of air. Using an Inhaler and Nebulizer 5 To take the medicine from the inhaler: 6. Put the spacer between your teeth and close your lips tightly around it. 7. Keep your chin up. 8. Begin to slowly breathe in through your mouth. 9. Press down on the inhaler to spray 1 puff into the spacer. 10. Keep breathing in slowly. Breathe in as deeply as you can. To get the medicine into your airway: 11. Remove the spacer from your mouth. 12. Hold your breath and count to 10 or more. 13. Slowly breathe out through your mouth while puckering your lips. 14. Depending on the dose your health care provider prescribed, you may have to take more than one puff of medicine. If this is the case, repeat steps 6-12. Using a Dry Powder Inhaler Some dry powder inhalers, or DPIs, can only hold one dose of medicine at a time. Other DPIs hold many doses. If your DPI holds only one dose, you will need to put medicine into it each time you use it. Some DPIs have a lever or button that you slide to open. Others have a piece that twists until you hear it click. Some DPIs have an opening that you push medicine into before using it. Dry Powder Inhaler 6 Using an Inhaler and Nebulizer A dry powder inhaler usually has 3 parts: • A container. • A valve. • A mouthpiece. To prepare the inhaler: 1. Remove the cover or cap from your DPI. 2. Open your DPI if you are required to put medicine into it. 3. Put a dose of medicine into the DPI if you are required to. 4. Breathe out slowly and steadily to empty your lungs of air. Using an Inhaler and Nebulizer 7 To take the medicine from the inhaler: 1. Close your lips tightly around the mouthpiece. 2. Keep your chin up. 3. Take a deep and fast breath using only your mouth. Do not breathe in through your nose. 4. Continue breathing in until your lungs are completely full of air. To get the medicine into your airway: 5. Remove the DPI from your mouth. 6. Hold your breath and count to 10 or more. 7. Slowly breathe out through your mouth while puckering your lips. Repeat these steps as many times as needed until you have taken the number of doses your health care provider prescribed. You should wait at least one minute. Knowing When to Replace Your Inhaler Some inhalers now include counters so you always know how many puffs are remaining in the device. For those that do not have counters, the number of puffs a canister contains is listed on the label so you can estimate the number used since first usage of the inhalers. 8 Using an Inhaler and Nebulizer Cleaning • The inhaler should be cleaned often to prevent buildup that will clog the inhaler. • Once a day, clean the inhaler and cap by rinsing them in warm running water. Let them dry before you use it again. • Once or twice a week, wash the plastic mouthpiece with mild dishwashing soap and warm water. Rinse and dry it well before putting it back. Nebulizers A nebulizer is an electric or battery powered machine that turns a liquid into a breathable mist. The mist is inhaled into the lungs. Nebulizers may use an air compressor or sound vibrations to turn the medicine into a breathable mist. You should work with your health care provider to decide which type of device best suits your needs. Studies show that nebulizers and inhalers work equally well when they are used correctly. Other studies confirmed that MDI is more effective treatment than nebulizers. Using an Inhaler and Nebulizer 9 In addition, using nebulizers had many disadvantages as the followings: • A nebulizer takes more time to use than an inhaler. Nebulizers often take 10 or 15 minutes to give medication, some nebulizers take longer. So the chances for more side effects of the medications such as increased heart rate and palpitation are higher. • Some nebulizers need to be plugged in to work. • Nebulizers may use an air compressor or sound vibrations to turn the medicine into a breathable mist. This makes them noisier than an inhaler. • Nebulizers are often heavier than inhalers. But they are still small and easy to carry. • Nebulizers are more expensive than inhalers. They also need maintenance. 10 Using an Inhaler and Nebulizer “This patient education handout is adapted from X-Plain Education” This document is for informational purposes and not Intended to be a substitute for the advice of a doctor or healthcare professional or a recommendation for any particular treatment plan.
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