LIVING WELL WITH COPD Instructions for Using an MDI Without a Holding Chamber Using a Metered-Dose Inhaler (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: • Priming the device (getting it ready to use) • • • Using the device Cleaning the device 1 SHAKE WELL STEP 1: Take the cap off your MDI. Check for and remove any dust, lint, or other objects. Shake the MDI well, if instructed in your patient information. 2 HOLD BREATH STEP 5: Hold your breath for 10 seconds. If you cannot hold your breath for 10 seconds, hold your breath for as long as you can. 6 Maintaining the device Priming When the MDI is new or hasn’t been used in 2 weeks, the ingredients may separate. Priming releases one or more sprays into the air. This helps ensure the dose you inhale has the right amount of medication. Read your patient instruction sheet for priming instructions, especially if you don’t use your medication every day. EXHALE FULLY STEP 2: Sit up straight, or stand up. Exhale fully, emptying your lungs as much as possible. 3 WAIT 1 MINUTE, SHAKE STEP 6: If you need to take another puff of medicine, wait 1 minute. After 1 minute, shake the MDI again if patient instructions recommend it. Repeat steps 2 through 5. 7 HOLD UPRIGHT STEP 3: Hold the inhaler upright with the mouthpiece at the bottom and the top pointing up. Position it in or in front of your mouth as instructed by your doctor or the medication’s patient instruction sheet. Some recommend holding the inhaler 1 to 2 inches away from your open mouth. Others recommend putting the MDI mouthpiece between your teeth and closing your lips tightly around it. Keep your tongue out of the way of the spray. 4 STEP 7: Recap the MDI. If your medicine contains an inhaled corticosteroid, rinse your mouth with water after your last puff of medicine. Spit out the water. DO NOT SWALLOW IT, to minimize the risk of yeast infection in your mouth. 8 COUNT DOSES INHALE SLOWLY STEP 4: Begin to inhale slowly, then activate the inhaler a split-second later. If you wait too long, you won’t have enough breath left. Inhale the medicine deep into your small airways. Continue inhaling SLOWLY for 3-5 seconds or until your lungs are full. 10 RINSE IF CORTICOSTEROID Counting Doses: Even the most perfectly timed inhalation won’t do you any good if there’s no medicine left in the inhaler. It’s important to: • Count each dose • Prime the spray • Replace the inhaler with a new one after using the labeled number of sprays Many MDIs now have dose counters built in. If yours does not, use a diary or other system to track doses used. Don’t rely on how the inhaler “feels.” The MDI may still spray or feel full when shaken long after the active medication has been used up.