Home > Blog > April 2017 > Treating Asthma: How to Use an Inhaler Properly

Treating Asthma: How to Use an Inhaler Properly

Posted: April 7, 2017 by Angel Bostic
Pima Medical Institute Respiratory Therapy instructor Angel Bostic poses with her students during an asthma conference in Houston.

Last month at the American Lung Association’s 2017 Asthma Educator Institute in Houston, doctors, nurses, respiratory therapists and medical assistants gathered together to continue education, learn more about asthma, and prepare to take the National Asthma Educator Certification Board Asthma Educator Examination. The burden of asthma, medications prescribed and how to create action plans to prevent exacerbations were some of the topics addressed. I was asked to lecture on the various medication devices available on the market, and I thoroughly explained the proper technique for using each device.  

Angel Bostic with Pima Medical Institute participates in the American Lung Association’s asthma conference. Angel Bostic, (left) Respiratory Therapy instructor at Pima Medical Institute’s Houston campus, is recognized for her contributions to asthma education during the American Lung Association’s 2017 Asthma Educator Institute. Rubina Abrol, MD, Asthma Programs Manager with the American Lung Association presented Bostic with a plaque during the conference.
Living in the golden age of Google and YouTube, it’s easy to take for granted the vast amount of articles and videos about medical information available at our fingertips. Despite having the ability to look up almost anything within seconds, you would be surprised to know that a study published in the Respiratory Care Journal in 2014 showed that the appropriate message is not reaching the masses, especially when it comes to using an inhaler the correct way. In the study, a group of researchers observed patients who took inhalers daily, and more than 80 percent of the patients used the device incorrectly. 

A major goal in all asthma action plans is to prevent a flair-up of the disease. According to the National Heart, Lung, and Blood Institute, well-controlled asthma in children 12 and older is defined as needing a rescue inhaler less than twice a week and one or less exacerbations requiring oral steroids per year.   There are multiple issues associated with reoccurring exacerbations of asthma such as poor quality of life, missed school days, lost work days, and costly visits to the emergency room – just to name a few. Did you know a very important factor in helping someone properly manage the disease is to make sure the patient knows how to use the inhaler correctly and understands when and how often to use it?

There are many inhaler devices on the market. A commonly prescribed rescue inhaler, albuterol, is available as an aerosol contained in a canister that sprays into the mouth when it’s activated. A drug in this formulary is referred to as a metered dose inhaler (MDI). 

Researchers suggest patients use it with a spacer, regardless if it’s a child or adult. However, many people have never heard of a spacer. Spacers provide some distance between the medication device and the mouth so that particles can be delivered at a slower speed, which helps the medication get into the lungs instead of impacting the back of the throat.  

Angel Bostic with Pima Medical Institute shows an audience how to properly use an inhaler. Angel Bostic demonstrates how to properly use an asthma inhaler during her presentation at the American Lung Association’s 2017 Asthma Educator Institute in March.
Many pharmacies only give spacers to children; that is, if they supply them at all. But so many patients place the inhaler directly into the mouth, spray and take a deep breath. On the contrary,
the optimal technique without a spacer requires a little coordination.

You may use an inhaler without a spacer by following these steps:

1. Open the mouth.
2. Place the inhaler about 4 centimeters away from the mouth.
3. Slowly start to inhale.
4. Spray the medication into the mouth.
5. Continue taking a slow, deep breath.    
6. Hold your breath for just a few seconds before exhaling.

As you can imagine, a small child may not be able to follow these instructions, which is why a spacer is necessary. Additionally, not all inhalers will follow the technique listed, so it is important to read the instruction manual or watch videos posted by drug manufacturers’ websites.

When a patient is prescribed more than one device, remembering how to use each one can be challenging. Here are some points to consider when helping someone, or yourself, use inhalers properly.

  • Do you have asthma or constantly provide guidance to someone with asthma? Take a moment to look up your inhaler and see if you are using it correctly.  
  • Clinicians should thoroughly understand the manufacturer’s usage guidelines. Drug companies have videos available on their websites to assist with techniques. Instructions are always included inside the box of the inhalers upon opening them.     
  • Asthma medications can be grouped into rescue or control inhalers. Rescue inhalers should always be available to you in your home in case of an emergency, but you should not have to take it every day if your asthma is well-controlled.  
  • Control inhalers should be taken even when you don’t perceive symptoms, and they should not be discontinued without a physician’s approval.  
  • Providers don’t always know the cost you will have to pay for the medication they prescribed.  Let your physician know if you cannot afford the medication ordered for you. Often, there is another option available.  
  • Some inhalers can be administered passively to children or adults that cannot follow directions, while some inhalers require the individual to follow instructions. If you feel the device does not work for the individual, call the doctor to see if there is another formulary available.   
  • If you can, use a spacer!
Although being diagnosed with asthma is not preventable, exacerbations can be prevented with a few easy steps such as verifying the inhaler is being used properly or providing useful tips. Even if you feel you have a great understanding on how the various devices are supposed to work, it won’t hurt anyone to review the manufacturer’s guidelines every once in a while just to be certain.

Thumb-(1).jpgAngel Bostic is a registered respiratory therapist and an instructor in the Respiratory Therapy Program at Pima Medical Institute’s Houston campus. She is a neonatal-pediatric specialist and especially enjoys working in the NICU at a major hospital system in Houston, TX.

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