Mastering Your Inhaler Technique

Using an inhaler seems straightforward, but it’s actually a high-precision task. If the technique isn't quite right, the medication often ends up hitting the back of your throat instead of reaching your lungs where it’s needed.

Here is a guide to help you master the puff.

The Pre-Game Checklist

Before you even take a breath, make sure the device is ready to perform.

 

• Check the Dose Counter: It sounds obvious, but many people keep “puffing” an empty canister. If it’s in the red or at zero, it's time for a replacement.
• Shake it Up: Most Metered-Dose Inhalers (MDIs) are suspensions. Shake the inhaler for 5 seconds to mix the medicine with the propellant. (Note: Dry Powder Inhalers do not need shaking).
• Prime the Pump: If you haven’t used the inhaler in a few days (or if it’s brand new), spray it twice into the air to ensure the next dose is full strength.

Perfecting the Technique

The goal is to create a clear “highway” for the mist or powder to travel down.

For Metered-Dose Inhalers (MDIs - the “L” shaped ones)

1. Exhale Fully: Breathe out away from the inhaler until your lungs feel empty. This creates space for the medication.
2. Posture Matters: Sit up straight or stand. Tilt your chin up slightly to straighten the airway.
3. The Slow Sip: Start inhaling slowly and deeply just as you press the canister. Think of it like a long, steady straw sip, not a quick gasp.
4. The 10-Second Hold: Hold your breath for 10 seconds (or as long as comfortable) to let the particles settle deep in the lungs.

For Dry Powder Inhalers (DPIs - like Diskus or Ellipta)

• The Quick Snap: Unlike MDIs, DPIs require a quick, forceful breath to “suck” the powder out.
• Keep it Dry: Never exhale into a DPI, as the moisture from your breath can clump the powder.

Pro-Tips for Better Results

Tip	Why it Matters
Use a Spacer	For MDIs, a spacer (valved holding chamber) catches the “mist” so you can breathe it in naturally. It's often more effective than "open mouth" techniques.
The 60-Second Rule	If you need two puffs of the same med, wait about one minute between them. This allows the lungs to open slightly from the first puff, making the second more effective. This is not true for inhaled corticosteroids and unlikely to make a difference with albuterol in most cases
Rinse and Spit	If your inhaler contains a steroid (preventer), always rinse your mouth with water and spit it out afterward to prevent oral thrush (a yeast infection).

Maintenance & Storage

• Clean the Plastic: Once a week, remove the metal canister and wash the plastic actuator with warm water. Let it air dry. Clogged nozzles lead to uneven doses.
• Temperature Control: Don't leave inhalers in a hot car. Extreme heat can cause the canister to burst or the medication to degrade.

Common Mistake to Avoid

The “Tongue Block”: Make sure your tongue is on the floor of your mouth. If your tongue is up, it acts like a shield, and the medicine just sticks to it instead of going down your windpipe.

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William Garst is a consultant pharmacist who lives in Alachua, Florida. He is semi-retired and works part time at Lake Butler Hospital in Lake Butler, Florida. William received his pharmacy degree at Auburn University and a Doctor of Pharmacy from Colorado University. The Pharmacy Newsletter is a blog where you can find other informative columns. He may be contacted at garstcph@gmail.com.

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