Asthma Inhalers

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• QWhat should I know about using asthma inhalers?

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  A American Dental Association answered

  People with asthma often use inhalers. Inhaling medication through your mouth can cause a fungal infection called oral candidiasis. Sometimes called thrush, this infection appears as white spots in your mouth and can be painful. Rinsing your mouth after using your inhaler may prevent this infection.

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• QHow can I track the medication doses in my inhaler?

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  A Intermountain Registered Dietitians , Nutrition & Dietetics, answered on behalf of Intermountain Healthcare

  Here’s how to track:
  
  1. Check the canister label to see how many “puffs” (metered doses or actuations) it contains.
  
  2. Figure out how many puffs you will take per day (for example, 2 puffs, 2 times a day = 4 puffs a day).
  
  3. Divide your answer from step 1 by your answer from step 2.
  
  4. On the canister, write the date that you start the inhaler. Also write the date you should discard it (based on your calculations).
  
  5. When you reach the “discard date,” throw away the canister and start a new one. If you keep an empty canister lying around, you’re likely to get it mixed up -- and then you won’t have medication when you need it.
• QHow do I use a metered-dose inhaler (MDI)?

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  A Intermountain Healthcare answered

  This is how to use a metered dose inhaler (MDI): Remove the cap from the inhaler, and from the spacer if necessary.

  1. If necessary, prime the inhaler (squirt a puff into the air). Check the package insert for specific instructions. Some MDIs don't need to be primed, and others need one, two, or more priming puffs.
  2. If you're using a spacer, insert the inhaler into the rubber end of the spacer.
  3. Shake the inhaler well immediately before each puff to mix and warm the contents.
  4. Breathe out.

  If you're using a spacer with a mouthpiece:
  

  1. Place the mouthpiece fully into the mouth between the teeth, holding the inhaler upright and closing the lips around the mouthpiece.
  2. Press the canister down to release a puff of medication.
  3. Breathe in deeply and slowly -- for 3 to 5 seconds -- through your mouth.
  4. Hold your breath for 10 seconds.
  5. Remove the spacer from your mouth and breathe out slowly.
  6. Repeat steps 4 through 10 for each inhalation prescribed by your doctor.

  If you're using a spacer with a mask:
  

  1. Place the mask over the child's mouth and nose, with the inhaler upright. Maintain the seal between the face and mask.
  2. Press the canister down to release a puff of medication.
  3. Encourage the child to breathe in deeply and slowly -- for 3 to 5 seconds -- when possible.
  4. Maintain the seal for 6 breaths while the child breathes in, then remove the mask from the face.
  5. Repeat steps 4 through 9 for each inhalation prescribed by the doctor.

  
  
• QHow should I clean my inhaler?

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  A Intermountain Registered Dietitians , Nutrition & Dietetics, answered on behalf of Intermountain Healthcare

  Clean the inhaler thoroughly and frequently:
  
  1. Remove the metal canister and cleanse the plastic case and cap by rinsing thoroughly in warm, running water. Be sure to clear medication build up from the spray nozzle.
  
  2. Thoroughly dry the plastic case and cap.
  
  3. Gently replace the canister in the case with a twisting motion, and put the cap back on the mouthpiece.
• QWhat are the long term effects of asthma inhalers?

  1 Answer

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  A Dr. Snehal R. Patel, MD , Emergency Medicine, answered on behalf of MDLIVE

  Several different types of inhalers are being used in practice today for asthma either as single (rescue) and/or in combination ( long-term prophylaxis). Their usage and dosing varies per severity and response of asthma patients. Nonetheless, each of them carries long-term side effects and must be used in proper dosage and frequency within prescribed limits.
  Albuterol is the most frequently used inhalers as rescue treatment for any asthma patient. Long-term use of it can increase asthma-related death with increased severity of asthma exacerbations, cardiac arrhythmias and hypertension. With frequent usage for long period it becomes ineffective and may lead to hyperinflation of lung.
  Long-term effects of inhaled corticosteroid are mostly dose related. Osteoporosis, weakened immune system and decreased velocity of growth in children are well-documented side effects.
  Formoterol and Salmeterol is the long acting b2 agonist (LABA) sometimes used for moderate and severe asthma control. Excessive and improper use of them leads to worsening bronchospasm, hypertensive crisis, cardiac arrhythmias and increased asthma-related deaths.
  Long-term effects of Cromolyn-sodium Inhalers are rare and still it is unclear whether they are related to drug itself. Some of these are nephrosis, vasculitis, polymyositis, exfoliative dermatitis, anemia, pulmonary infiltrate with eosinophis and hemoptysis.
  In general, patients should minimize use of rescue inhalers. Steroid inhalers in lowest effective dose are recommended for prophylaxis of asthma.
   
   
   
• QWhy should I use a holding chamber with my inhaler?

  2 Answers

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  A Dr. Donna Bond, DNP , Nursing, answered on behalf of Sigma Nursing

   
  A holding chamber, sometimes called a spacer, can be used with inhalers to increase the amount of medication that is inhaled into the airways.  This device is a long tube that allows the person with asthma to slowly breathe in the medication.  This makes it easier for more of the medication to get to the lungs and less medication to be left in the mouth and throat.   

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• QWhat are the types of asthma inhalers?

  1 Answer

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  A Intermountain Registered Dietitians , Nutrition & Dietetics, answered on behalf of Intermountain Healthcare

  Many asthma medications come in small, hand-held devices called inhalers. There are two main types:
  
  • Metered dose inhalers, or MDI, deliver medication in fixed, measured amounts. Some inhalers have a pressurized canister that sprays out medication when you press down on it.
  
  • Dry-powder inhalers contain powdered medication that’s released when you breathe in through a mouthpiece. There are many different types of dry-powder inhaler devices. Always follow the instructions provided with your prescription.
• QHow does a metered dosed inhaler (MDI) deliver asthma medication?

  1 Answer

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  A American Red Cross answered

  A metered dose inhaler (MDI) sends a measured dose of medicine in mist form directly into the person’s mouth. The person gently presses down the top of the inhaler.
  
  This causes a small amount of pressurized gas to push the medicine out quickly. Sometimes a “spacer” is used to control the amount of medication that is inhaled.
  
  The medicine goes into the spacer and then the person inhales the medication through the mouthpiece on the spacer.
  
• QHow does a dry powder inhaler (DPI) deliver asthma medication?

  1 Answer

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  A American Red Cross answered

  A dry powder inhaler (DPI) is a hand-held device that delivers a dry powder form of the medication. Some dry powders are tasteless. Others are mixed with lactose to give them a sweet taste.
  
  The DPI is administered by breathing in quickly to activate the inhaler. The person does not have to press down the top of the inhaler. DPIs may be difficult for some people to use because of the need to take in a quick, strong breath.
  
• QHow should I help someone with an asthma inhaler?

  1 Answer

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  A American Red Cross answered

  

  TIP: Always obtain consent before giving care and wash your hands immediately after giving care. Read and follow all instructions printed on the inhaler prior to administering the medication to the person.
  
  If the person has medication for asthma, help him or her take it if asked:
  

  • Help the person to sit up and rest in a position comfortable for breathing.

  
  

  • Ensure that the prescription is in the person’s name and is prescribed for “quick relief” or “acute” attacks.
  • Ensure that the expiration date of the medication has not passed.
  • Shake the inhaler.
  • Remove the cover from the inhaler mouthpiece.

  
  

  • If an extension tube (spacer) is available, attach and use it.
  • Tell the person to breathe out as much as possible through the mouth.

  TIP: The person may use different techniques, such as holding the inhaler two-finger lengths away from the mouth.
  

  • Have the person place his or her lips tightly around the mouthpiece and take a long, slow breath.

  1. As the person breathes in slowly, administer the medication by quickly by pressing down on the inhaler canister, or the person may self-administer the medication.
  
  
  
  2. The person should continue a full, deep breath.
  3. Tell the person to try to hold his or her breath for a count of 10.
  4. When using an extension tube (spacer), have the person take 5 to 6 deep breaths through the tube without holding his or her breath.
  

  • Note the time of administration and any change in the person’s condition. The medication may be repeated once after 1 to 2 minutes.
  • Have the person rinse his or her mouth out with water to reduce side effects.

  
  

  • Stay with the person and monitor his or her condition, and give care for any other conditions.
  • Care for shock.
  • Keep the person from getting chilled or overheated.
  • Call 9-1-1 or the local emergency number if trouble breathing does not improve quickly.

  TIP: These medications might take 5 to 15 minutes to reach full effectiveness. Follow label instructions regarding additional doses of the medication.