Inhalers

Question 1

What are the different types of inhalers?

Answer 1

MDIs –pressurised Metered Dose Inhalers –generates an ‘aerosol’ which is inhaled
DPIs –dry powder inhalers –the ‘dry powder’ is inhaled
SMIs –soft mist inhalers –the ‘soft mist’ is inhaled.

Question 2

What are the different drug groups of inhalers?

Answer 2

SABA =Short Acting Beta Agonistb
LABA = Long Acting Beta Agonistc
SAMA = Short Acting Antimuscarinic (rarely used in asthma)
LAMA = Long Acting Antimuscarinic (rarely used in asthma)
ICS = Inhaled corticosteroids

Question 3

Explain how to use a pMDI

Answer 3

Test it if it’s the first time using it or haven’t used it for over 5 days. The number of sprays depends on the type of inhaler, so read the label. Check there is nothing in the mouthpiece after taking off the cap. Shake the inhaler. Sit of stand up straight and tilt your chin up. Breathe out genly and slowly away from the inhaler until your lungs feel empty. Make a tight seal around the inhaler. Breathe in slowly whilst pressing the inhaler button. Breathe in until your lungs feel full. Take the inhaler out and hold your breath for 10 seconds or until comfortable. If second puff, wait 30 seconds to a minute whilst shaking and repeat. If a steroid, rinse your mouth with water to reduce side effects.

Question 4

Explain how to use a spacer on a child

Answer 4

Child can sit sideways. Check there is nothing in the mouthpiece after taking off the cap. Shake the inhaler. Put the inhaler into the hole at the back of the spacer and put the mask on. Create a seal. Encourage child to breathe in and out. One press, child breathe 5 times slowly and steadily.

Question 5

Explain how to use a spacer in an adult

Answer 5

Explain it helps to get more of the medication into your lungs. Check it isnt empty and nothing inside the mouthpeice. Shake the inhaler well. Put inhaler into the hole at the back of the spacer and place the mask on with the nose facing up. Sit/stand but slightly tilt chin, press cannister and breathe slowly and steadily 5 times. Remove mask. This is multiple breathing technique. The alternative is the single hold breath technique which would be when you breath out slowly until your lungs feel empty before putting the mask on and then breathe in slowly and steadily till you feel full. Hold your breath for 10 seconds. Then breathe gently.

Question 6

Explain how to use a turbohaler

Answer 6

First, twist off the cover, and hold the Turbohaler upright, with the coloured base at the bottom. Turn the coloured base as far as it will go in one direction, and then all the way back again. You should hear a click on one of these turns. Repeat. When you use your inhaler again, you don’t need to repeat these steps.
Check there’s nothing inside the mouthpiece. Check the dose counter to make sure the inhaler isn’t empty. When there are only 20 doses left in the inhaler, a red strip will appear in the top of the window. When it gets to the bottom of the window, this means your inhaler is empty. Hold the inhaler upright. Turn the coloured base to the right as far as it will go, and then to the left until you hear a click. Your dose is now ready.
Sit or stand up straight and slightly tilt your chin up. Breathe out gently and slowly away from the inhaler until your lungs feel empty and you feel ready to breathe in. Hold the inhaler horizontally, but don’t tip it upside down as the powder may fall out. Put your lips around the mouthpiece to make a tight seal. Then breathe in quickly and deeply until your lungs feel full. Take the inhaler out of your mouth and hold your breath for up to 10 seconds Then breathe out gently away from the inhaler. Rinse mouth with water to avoid side effects.