By Stefanie Black
Pharmacist at Thrifty Foods Pharmacy in James Bay
People get started on inhaled medications for a variety of reasons such as asthma or COPD (chronic obstructive pulmonary disease). Over 50 percent of people don’t properly use their inhaling devices.
Metered-dose inhalers (examples: Ventolin, Flovent) use a propellant to help carry drug into the lungs. Most of these devices need to be shaken well before each puff. Once you are ready to take your dose, start breathing in and press down as you breathe in slowly and deeply. Breathing slow and deep helps to limit how much drug hits the back of the throat and tongue, meaning there is more medication in the lungs. If coordinating breathing in and pressing down is difficult for you, you may benefit from a spacer device. The device improves how much medication you get into the lungs and solves the issue of timing.
Dry-powder inhalers (examples: Advair Diskus, Spiriva, Symbicort) use the force of your breath to pull medication into the lungs. There are many devices that use a dry powder and they can be in the form of a blister, reservoir, or capsule that has to be exposed before inhaling. Single-dose devices need a capsule inserted into the device and pierced once for each dose but may need two inhalations to get all the medication out. The piercing of the capsule varies for each device. Multi-dose devices load the dose by moving a lever, twisting a base, or opening a cap.
For all of these dry powder devices, you want to hold the device level. Once you have opened where the dry powder is stored, it can be accidentally dumped out, so do not shake these devices or flip them upside down after that point. Once you are ready to take your dose, inhale quickly and deeply. These devices may not be the best for you if you have a hard time taking a deep, quick breath.
For all devices, make sure to breathe out away from the device first before taking your dose. After taking your dose, you want to hold your breath for 10 seconds. This keeps the medication in the lungs longer and improves its use. Another important tip is to remember to rinse your mouth with water and spit after using any medications containing corticosteroids. The rinsing removes residual medication that gets stuck in the mouth and keeps it just in the lungs where you need it. Corticosteroid medications come in a variety of different devices, so check with your pharmacist if you aren’t sure if you are taking one or which one it is.
There are many different devices with different functionality including dose counters, colour changes when dose received, and easy loading for people with dexterity issues such as arthritis. Often people find it easier to use only one type of device even if they need multiple types of medications to keep things simple. Check with the doctor or pharmacist if you think you may benefit from using just one type.
If you have any questions about your technique with inhaler devices, go to your pharmacy and have them review your technique. This article doesn’t cover every single inhaler device and there are tips and tricks with each type.