Inhalers for Respiratory Disease

Inhalers are convenient and portable devices that deliver consistent doses of medicine directly to your lungs. They can be used with different types of respiratory disease medication. Some inhalers are used every day, and others are prescribed only for flare-ups.

Using an inhaler also requires some coordination, and different inhaler brands may work slightly differently. You should always take your medicine as prescribed and follow the manufacturer’s instructions on how to use your inhaler correctly.

This is a general introduction to inhaler types and use. If you would like instructions specific to your brand, the COPD Foundation has an excellent series of how-to videos here.  

In this Article

• How to Use an Inhaler
• Types of Inhalers
• Closed Mouth Technique vs. Spacers

How to Use an Inhaler

There are a few important guidelines you should follow regardless of what type of inhaler you are prescribed:

• Wash your hands before and after use. Washing your hands before keeps germs, dirt, and bacteria away from the mouthpiece. It’s also important to wash after because some inhaled medication can irritate your skin and eyes.    
• If you’re taking corticosteroids, rinse your mouth after using your inhaler. Corticosteroids can cause an infection if left in the mouth for too long. Remember—do NOT swallow the water you rinse with.
• Know when your medication will expire. Use your inhaler within 12 months of opening it, or by the expiration date, whichever comes first. Keep your inhaler in its original packaging until you’re ready to use it, and store it in a cool, dry place—or according to the manufacturer’s instructions.  

Types of Inhalers

There are three different types of inhalers: pressurized metered-dose, dry powder, and soft mist. 

1. Pressurized metered-dose inhaler (MDI)

An MDI is made up of three parts: a small, pressurized canister, which fits into a plastic boot-shaped holder, and a mouthpiece. 

How to Use Your MDI

If you are using a brand new MDI—or using your inhaler for the first time in a few days—shake it well, according to the manufacturer’s instructions. Check the expiration date, and then spray one to two puffs of medicine in the air to prime the device. 

Exhale fully. 

To inhale the medication, press the button at the top of the inhaler and take a slow, deep breath at the same time. Then hold your breath for ten seconds—or for as long as you are able—and exhale slowly.

If your doctor has told you to take more than one puff, wait 30 seconds before the next dose. Shake the inhaler before each puff. 

You can inhale the medicine directly from the mouthpiece using the “closed mouth technique”, or you can use a spacer. A spacer is a short plastic tube that connects to your inhaler. More information about how to use spacers and the closed mouth technique is below.  

When you have taken your prescribed dose of medication, put the cap back on your mouthpiece to keep it clean.  

2. Dry powder inhaler

A dry powder inhaler contains just powdered medicine. It does not have a pressurized canister. Dry powder inhalers come in different shapes and sizes, so always read the manufacturer’s instructions on how to dispense your medication. And always check the expiration date before use. 

How to Use Your Dry Powder Inhaler

Exhale fully.

To inhale the medication, take a slow deep breath. Then hold your breath for ten seconds—or for as long as you are able—and exhale slowly.

Put the cap back on the inhaler to keep it clean. Remember to wash your hands after use because some powdered medicine can irritate your skin and eyes.

3. Soft mist inhaler

A soft mist inhaler (SMI) uses a spring to release medication in a fine mist that you breathe in. The cartridge that contains the medicine is packaged separately from the dispenser, so make sure to read the manufacturer’s instructions on how to put them together.

How to Use Your Soft Mist Inhaler

When you use an SMI for the first time, you need to prime the device by pressing the release button until you see a puff of medicine come out. If you are using an SMI that has already been opened, check the expiration date. 

Exhale fully. 

To inhale the medicine, breathe in slowly and deeply. Then hold your breath for ten seconds—or for as long as you are able—and exhale slowly. Repeat this process if you are prescribed more than one dose. 

The inhaler will lock once you have taken your full dose. Close the cover of your inhaler to keep it clean.

Closed Mouth Technique vs. Spacers

Timing is important with an MDI because it allows you to get the most benefit from your medication. If you are breathing directly from your inhaler using the closed mouth technique, you must inhale as you release the medication.  

But sometimes it can be tricky to coordinate your breath, especially if you’re experiencing a flare-up. So some people prefer to use a spacer instead. A spacer is a clear plastic tube that connects to the inhaler, and it slows down the delivery of the medication. This means you don’t have to worry about breathing in at the same time you release your medication.

Closed Mouth Technique

1. Wash and dry your hands. 
2. Attach the canister to the mouthpiece and prime it by spraying a few puffs in the air.
3. Sit up straight and exhale fully.
4. Hold the inhaler upright and put the mouthpiece between your lips, making a seal around it. Make sure your tongue is below the mouthpiece and not blocking the flow of medication.
5. Press down on the inhaler while you are taking a slow deep breath.
6. Hold your breath for 10 seconds or as long as you can, and then exhale fully.
7. If your doctor has told you to take more than one dose, wait 30 seconds before the next puff.
8. Replace the mouthpiece cover after you are finished using the inhaler.

Other tips:

• If you are taking a corticosteroid, remember to rinse your mouth with water. Do not swallow the water! 

Spacer Technique

You can follow along with a Wellinks instructional video here. 

1. Wash and dry your hands.
2. Attach the mouthpiece of the inhaler to the back of the spacer and shake it for 10 seconds.
3. Exhale fully.
4. Put your mouth on the mouthpiece of the spacer and press down on the inhaler to release the medication.
5. Breathe in slowly and deeply.
6. Hold your breath for 10 seconds or for as long as you are able.  
7. If your doctor has told you to take more than one dose, wait 30 seconds before the next puff. Remember to shake the inhaler before each puff.

Other tips:

• If you have trouble remembering when you need to take your medicine, consider using a dry erase marker to write the time of your last dose on your spacer. 
• If your spacer makes a whistling sound when you breathe in, this just means you inhaled too quickly. Don’t worry! You don’t need to retake your medication, just try to breathe in more slowly next time.  
• If you are taking a corticosteroid, remember to rinse your mouth with water. Do not swallow the water!