Administration of Medications with Metered-Dose Inhalers

Instruct patient on the proper use of the metered-dose inhaler. There are 3 methods of using a metered-dose inhaler. Shake inhaler well. (1) Take a drink of water to moisten the throat; place the inhaler mouthpiece 2 finger-widths away from mouth; tilt head back slightly. While activating the inhaler, take a slow, deep breath for 3–5 sec; hold the breath for 10 sec; and breathe out slowly. (2) Exhale and close lips firmly around mouthpiece. Administer during second half of inhalation, and hold breath for as long as possible to ensure deep instillation of medication. (3) Use of spacer. Consult health care professional to determine method desired prior to instruction. Allow 1–2 min between inhalations. Rinse mouth with water or mouthwash after each use to minimize dry mouth and hoarseness. Wash inhalation assembly at least daily in warm running water.

For use of dry powder inhalers, turn head away from inhaler and exhale (do not blow into inhaler). Do not shake. Close mouth tightly around the mouthpiece of the inhaler and inhale rapidly.

Steps for Using Your Inhaler

1. Remove the cap and hold inhaler upright.

2. Shake the inhaler.

3. Tilt your head back slightly and breathe out slowly.

4. Position the inhaler in one of the following ways (A or B is optimal, but C is acceptable for those who have difficulty with A or B. C is required for breath-activated inhalers):






5. Press down on the inhaler to release medication as you start to breathe in slowly.

6. Breathe in slowly (3 to 5 seconds).

7. Hold your breath for 10 seconds to allow the medicine to reach deeply into your lungs.

8. Repeat puff as directed. Waiting 1 minute between puffs may permit second puff to penetrate your lungs better.

9. Spacers/holding chambers are useful for all patients. They are particularly recommended for young children and older adults and for use with inhaled corticosteroids.

Avoid common inhaler mistakes. Follow these inhaler tips:

• Breathe out before pressing your inhaler.

• Inhale slowly.

• Breathe in through your mouth, not your nose.

• Press down on your inhaler at the start of inhalation (or within the first second of inhalation).

• Keep inhaling as you press down on inhaler.

• Press your inhaler only once while you are inhaling (one breath for each puff).

• Make sure you breathe in evenly and deeply.

• If you are using a short-acting bronchodilator inhaler and a corticosteroid inhaler, use the bronchodilator first, and allow 5 minutes to elapse before using the corticosteroid.

Other inhalers have become available in addition to the one illustrated here. Different types of inhalers may require different techniques.

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