| In order for the inhaled drugs that we prescribe to work, they must get to the lungs. Generally, patient technique using these devices is poor. Studies have also shown that physician understanding of proper technique is less than ideal.1 The following diagrams will demonstrate the optimal ways of using these devices. | |
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The turbuhaler is one of the easiest devices to use. The patient simply rotates the bottom until it clicks, then after emptying the lungs, the patient places the device in the mouth and takes a quick deep breath, holding it for 5 to 10 seconds. Failure to take quick sharp breath is one of the few ways the turbuhaler can be improperly used. |
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The diskus is another dry powder device that is easy to use. The patient simply opens it, depresses the trigger, places the device in the mouth mouth, tilts the head back slightly and after emptying the lungs takes a deep sharp breath. Once again with this device it is important to take a quick deep breath. |
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The Metered Dose Inhaler (MDI) is one of the most difficult devices to use effectively. First the patient must shake it. Then holding it about two finger breadths away from the mouth the patient must exhale, and then spray the aerosol into the wide open mouth. The the patient must then inhale slowly and hold the breath for 5 to 10 seconds. Improper timing is the most common problem associated with the use of MDIs. Placing the device in the mouth delivers most of the aerosol to the roof of the mouth rather than to the lungs. |
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The aerochamber eliminates many of the problems associated with the MDI. The patient sprays the aerosol into the chamber and then breathes in slowly. Once again the breath should be held for 5-10 seconds |
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To use the peak flow meter properly, the patient must take a deep breath and then blow quickly and sharply into the flow meter. Improper techniques include placing one's hand over the end of the peak flow meter, placing a finger or thumb over the meter so as to impede the measurement stylus, or blowing without first taking a deep breath. |
| Every patient should have a review of technique at least twice a year. | |
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Reference: 1. Resnick et al. Physician's MDI technique after a single teaching session. Ann of Allergy, Asthma and Immunology 76 145-8, 1996You can search for abstracts of the above references by following this link: PubMed Return to Archives Page ] [ Berries Home Page |