The Most Common Mistakes when Using an Inhaler

Inhalers are a daily fact of life for tens of millions of Americans, including 11 million with asthma and Chronic Obstructive Pulmonary Disease (COPD). Nevertheless, studies show that two-thirds of people do not use their inhaler correctly.

Research at the Baylor College of Medicine, in Houston, Texas identified nine separate steps required for using an inhaler, and found that no patient they studied — including those who had been using inhalers for years — had proper technique.

What happens when inhalers are used incorrectly? A study at Rice University found that without proper technique, only 7% to 40% of medication actually reaches the lungs of an inhaler user.

The most common mistakes include:

  1. Not shaking the inhaler enough before using it. An inhaler contains both medication and propellant. It needs to be shaken 10-15 times before each use in order to combine them thoroughly.
  2. Positioning the inhaler incorrectly. A deviation of as little as 5 degrees from the correct position can cause the medication to remain in the mouth, rather than reaching the lungs. Using a spacer aids in avoiding this problem.
  3. Inhaling and exhaling too quickly. To properly reach the lungs, each puff should be inhaled for approximately five seconds, held in for ten seconds, then breathed out through the mouth for ten seconds.
  4. Taking a second puff too soon. If instructions are to take two puffs of an inhaler, it is important to allow the first puff enough time to open the passageways so that the second puff can reach further. Taking that second puff too soon is not merely useless, it can lead to trembling and shakiness rather than relief.
  5. Not cleaning the inhaler. The plastic mouthpiece of the inhaler should be rinsed at least once a week. This removes build-up of medication that can block a full dosage of spray.

Using a spacer aids in avoiding both the problem of positioning and of inhaling too quickly.

Asthma and COPD lead not only to increased mortality, but also to reduced quality of life. Managing them properly is essential. COPD sufferers should enroll in a pulmonary rehabilitation program in order to exercise their lungs, increase their fitness, as well as learn how to manage their disease with medications, including proper usage of their inhaler.

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