Using an MDI
MDIs look the same on the outside , but each brand operates and needs to be maintained differently . Check the patient instruction sheet that came with your inhaler for details on using , cleaning , priming ( getting ready to use ), and maintaining the device .
A valved holding chamber attaches to the MDI and has a one-way valve designed to allow the patient to load the chamber with the medication and inhale it when ready or over several breaths . It can be used with a mask attachment for young children and others .
Priming When the MDI is new or hasn ’ t been used in a while , the ingredients may separate . Priming , or releasing one or more sprays into the air , helps ensure the dose you inhale has the right amount of medication . Consult your patient instruction sheet for priming instructions , especially if you don ’ t use your medication every day .
Counting Doses Even the most perfectly timed inhalation won ’ t do you any good if there ’ s no medicine left in the inhaler . That ’ s why it ’ s important to count each dose and priming spray and replace the inhaler after using the labeled number of sprays . Many MDIs now have dose counters built in . If yours does not , use your Asthma Diary to keep track of doses used . Don ’ t rely on how the inhaler “ feels .” Due to the many ingredients that make up the medication spray , the MDI may continue to spray or feel full when shaken long after the active medication has been used up .
Optimal Inhalation Technique Studies show that many patients do not use their inhaler properly , and therefore do not get the expected and needed full dose of medication . You must inhale the spray quickly enough to prevent it from landing on your tongue or inside your cheek , yet slowly enough to let it get deep into your lungs .
Many people , especially children , have trouble doing this correctly . A common solution is to use a spacer or valved holding chamber ( VHC ). Available by prescription , these devices are designed to improve the delivery of the medication to the lower airways as well as decrease two common side effects of medication delivery : thrush ( candidiasis ) and hoarseness ( dysphonia ).
A spacer is an open tube placed on the mouthpiece of the MDI to increase the distance between the MDI and the patient ’ s mouth and to direct the medicine through the chamber . Patients must still coordinate their breathing with the inhaler actuation .
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