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Metered-dose inhaler (MDI) administration - with spacer

Metered-dose inhalers (MDI) usually have 3 parts:

• A mouthpiece
• A cap that goes over the mouthpiece
• A canister full of medicine

If you use your inhaler the wrong way, less medicine gets to your lungs. A spacer device will help. The spacer connects to the mouthpiece. The inhaled medicine goes into the spacer tube first. Then you take two deep breaths to get the medicine into your lungs. Using a spacer wastes a lot less medicine than spraying the medicine into your mouth.

Spacers come in different shapes and sizes. Ask your doctor which spacer is best for you or your child. Almost all children over age 3 can use a spacer. You do not need a spacer for dry powder inhalers.

The steps below tell you how to take your medicine without a spacer. They are based on instructions from the National Heart, Lung, and Blood Institute.

Getting Ready

• Take off the cap off the inhaler and spacer.
• Shake the inhaler hard.
• Attached the spacer to the inhaler.
• If you have not used the inhaler in a while, you may need to prime it. See the instructions that your inhaler came with for how to do this.
• Breathe out gently to empty your lungs

Breathe in Slowly

• Put the spacer between your teeth, and close your lips tightly around it.
• Keep your chin up.
• Start breathing in slowly through your mouth.
• Spray 1 puff into the spacer by pressing down on the inhaler.
• Keep breathing in slowly. Breathe as deeply as you can.

Hold Your Breath

• Take the spacer out of your mouth.
• Hold your breath as you count to 10, if you can.
• Then, pucker your lips and slowly breathe out through your mouth.
• After using your inhaler, rinse your mouth with water, gargle, and spit out. This will help reduce unwanted side effects from your medicine.

Keep Your Inhaler Clean

Look at the hole where the medicine sprays out of your inhaler. If you see powder n or around the hole, clean your inhaler. First, remove the metal canister from the L-shaped plastic mouthpiece. Rinse only the mouthpiece and cap in warm water. Let them air dry overnight. In the morning, put the canister back inside. Put the cap on. Do not rinse any other parts.

Replacing Your Inhaler

For control medicines you take each day, write the date you need to replace it on the canister.

To figure out this date, use the number of puffs you take each day and the number of puffs your canister contains. For example, say your new canister has 200 puffs (number of puffs is listed on canister), and your doctor tells you to take 8 puffs each day. This canister will last 25 days. If you started using this inhaler on May 1, replace it on or before May 25. Write May 25 on your canister.

Do NOT put your canister in water to see if it is empty. This does not work.

Storing Your Inhaler

Store your metered-dose inhaler at room temperature. It may not work well if it is too cold. The medicine in the canister is under pressure. So, make sure not to get it too hot or puncture it.