Metered-Dose Inhaler, How to Use: Teen Version

The metered-dose inhaler (MDI) is a container of medicine that releases a mist of medicine. You inhale the medicine through your mouth into the airways of your lungs.

Inhaled asthma medicines contain a gas that helps the medicine get into your lungs. Chlorofluorocarbon (CFC) is the gas that used to be used in inhalers. Because it depletes the ozone layer in our atmosphere, hydrofluoroalkane (HFA) is now used instead. Although the gas in inhalers has changed, the medicine in HFA inhalers is the same as the medicine in CFC inhalers. The HFA inhaler looks just like a CFC inhaler but is a little different. The spray comes out with less force, is warmer, and has a slightly different taste. It is not felt as much in the throat when inhaled, but you still get the right amount of medicine.

The inhaler can be used alone, but it is highly recommended that you use a spacer attached to the inhaler because it helps you get more medicine into your lungs.

Several different types or combinations of medicines are available as metered-dose inhalers, including:

• bronchodilators (albuterol, ProAir HFA, Proventil HFA, Ventolin HFA, or Maxair)
• inhaled steroids (Flovent HFA, Pulmicort, Qvar)
• combinations of a long-acting bronchodilator and an inhaled steroid (ADVAIR HFA, Symbicort)
• ipratropium bromide (Atrovent HFA).

If you are using more than one type of inhaler, you will usually use the bronchodilator first.

There are several ways to use an inhaler. If you do not have a spacer available, the technique most often recommended is as follows:

1. Shake the inhaler vigorously.
2. If the inhaler has not been used before or if the inhaler has not been used for a while, you must prime the inhaler. Do this by spraying 2 or 3 sprays of the medicine into the air. (Each time you use the inhaler, the next dose is drawn into a chamber inside the inhaler. If the inhaler has not been used or sits for a long time without being used, some of the medicine leaks out of the holding area. This means you will not get the full dose of medicine the next time it is used. Priming the inhaler makes sure that you get the full dose of the medicine.)
3. Hold the inhaler upright so the mouthpiece is at the bottom.
4. Breathe out normally.
5. For many inhalers the best way to get the medicine into your lungs is to open your mouth wide and hold the mouthpiece 1 to 2 inches (about 2 to 3 finger widths) in front of your mouth. This method increases the amount of medicine that gets into your lungs. It helps medicine reach your lungs rather than the back of the throat.

   The best way to use some other types of inhalers is to place the inhaler mouthpiece directly into your mouth and close your lips snugly around it.

   Talk with your healthcare provider or pharmacist about the best way to use the inhaler that has been prescribed for you.

6. Press the inhaler down once so it releases a spray of medicine into your mouth while you breathe in slowly. (One spray is called a puff.) Continue breathing in as slowly and deeply as possible.
7. Hold your breath for 10 seconds or as long as is comfortable. This gives the medicine time to reach your airways.
8. Breathe out slowly.

After taking a few normal breaths, repeat steps 1 through 8 for another inhalation (puff) if required. Take the number of puffs prescribed by your healthcare provider.

If you are taking an inhaled steroid medicine rinse your mouth with water after the last dose and spit the water out.

Wash the plastic case for the inhaler once a week with soapy tap water. Rinse well and let the parts air dry.

Do not store your inhaler in places that may get very hot or cold (like a car).