Inhaler Education

A Metered Dose Inhaler (MDI) is a device used to deliver a variety of respiratory medicines. Some more common medicines found in the MDI include albuterol (ProAir®) and Symbicort® (combination budesonide and formoterol).

Using your MDI without Spacer (e.g., albuteroal, proventil®)

1. Shake the inhaler hard up and down 5 times.
2. Uncap inhaler and spacer mouthpieces and look for loose objects in the devices.
   IF PRIMING IS NEEDED: Push down inhaler canister one time, spraying into the air away from your face. Shake 5 times more and spray 3 times into the air.
3. Breathe OUT normally and away from the spacer. Don’t breathe in until step #5.
4. Put the inhaler mouthpiece in your mouth between your teeth. Close your lips around the inhaler mouthpiece and keep your tongue out of the way of the mouthpiece.
5. Start to breathe in slowly and press down on the inhaler canister 1 time. Continue to breathe IN slowly to fill your lungs full of medicine.
6. Take inhaler OUT of your mouth. Hold your breath for 5 to 10 seconds. We want to keep your lungs filled with medicine for 5 to 10 seconds.
7. Breathe OUT normally.
8. Wait 30 to 60 seconds before repeating steps 1-8 for the second puff.

A spacer (also known by its brand name, Aerochamber) can help deliver any medicine given by Metered Dose Inhaler (MDI). A spacer can be used by children and adults to help ensure the proper dose of respiratory medicine is received.

Watch a video to learn how to use a Metered Dose Inhaler with a Spacer

Asmanex® Twisthaler® is a device used to deliver a mometasone, an inhaled corticosteroid used to treat respiratory conditions. Asmanex® Twisthaler® is usually used as a “controller” medicine, meaning it should be used on a regular basis regardless of symptoms, but should always be used as prescribed by your healthcare provider.

Breo® Ellipta® is a device used to deliver a combination of two medicines for the treatment of COPD. Breo® Ellipta® includes fluticasone furoate, an inhaled corticosteroid, and vilanterol, a long acting bronchodilator. This inhaler is usually used as a “controller” medicine, meaning it should be used on a regular basis regardless of symptoms, but should always be used as prescribed by your healthcare provider.

Using your Breo® Ellipta®

1. Slide the cover down to expose the mouthpiece until it clicks. The dose counter will count down by one.
2. Breathe OUT fully and away from the device.
3. Put the device in your mouth with your lips firmly around the mouthpiece. Your lips should fit over the curved shape of the mouthpiece. When holding the inhaler, do not block the air vent with your fingers.
4. Take one long, steady, deep breath in through your mouth. Do not breathe in through your nose.
5. Remove the inhaler from your mouth and hold your breath for about 3 to 4 seconds.
6. Breathe OUT slowly and gently.
7. Slide the cover up and over the mouthpiece as far as it will go. Do not take another dose from the inhaler even if you do not feel or taste the medicine.

The Combivent® Respimat® Inhalation Spray device is a medicine that is FDA approved for the treatment of Chronic Obstructive Pulmonary Disease (COPD). It contains a combination of two medicines, ipratropium bromide (an anticholinergic) and albuterol (a short-acting beta agonist). This medicine is typically used as a “controller” medicine and should be used everyday as prescribed by your healthcare provider.

A Diskus is a device used to deliver a variety of respiratory medicines. A Diskus can contain one medicine or a combination of medicines. Some common medicines found in the Diskus include salmeterol (Serevent Diskus®) and Advair® (combination fluticasone and salmeterol).

Using your Diskus

1. Place your thumb on the thumb grip and push the thumb grip until it clicks into place and the mouthpiece appears.
2. Hold the Diskus® horizontal and upright (through step #6). Slide the lever away from you until it clicks.
3. Breathe OUT normally and away from the Diskus®. Don’t breathe in until step #5.
4. Put the Diskus® in your mouth with lips tight around the mouthpiece. Keep Diskus® horizontal.
5. Breathe IN guickly to fill your lungs full of medicine.
6. Hold your breath for s to 10 seconds and then take the Diskus® out of your mouth. We want to keep your lungs filled with medicine for 5 to 10 seconds.
7. Breathe normally.
8. Close the Diskus® by placing your thumb in the thumb grip and clicking it closed.
9. Store in a cool, dry place. If moisture and steam get into the Diskus® you may not get enough medicine.
10. Gargle your mouth and throat with water to reduce the risk of side effects.

Foradil® Aerolizer® is a device used to deliver formoterol, a long-acting beta agonist, used to treat respiratory conditions. Foradil® Aerolizer® is usually used as a “controller” medicine, meaning it should be used on a regular basis regardless of symptoms, but should always be used as prescribed by your healthcare provider.

Pulmicort® Turbuhaler® is a device used to deliver budesonide, an inhaled corticosteroid, used to treat respiratory conditions. Pulmicort Turbuhaler FDA approved to treat asthma in the US. Pulmicort Turbuhaler is usually used as a “controller” medicine, meaning it should be used on a regular basis regardless of symptoms, but should always be used as prescribed by your healthcare provider.

Using your Pulmicort® Turbuhaler® (budesonide)

1. Twist and remove cover.
2. Hold the inhaler upright with mouthpiece facing up.
3. Twist grip to right then left until it clicks. This gets the medicine ready for breathing in.
4. Breathe OUT normally and away from the inhaler. Don’t take a breath until step #6.
5. Put the inhaler in mouth with lips tight around mouthpiece. Inhaler may be held upright or horizontal.
6. Breathe IN quickly to fill you lungs full of medicine.
7. Hold your breath for 5 seconds and then take the device out of your mouth. We want to keep your lungs filled with medicine for 5 seconds.
8. Breathe IN and OUT normally.
9. Replace cover and twist to close, and store device in a cool, dry place.
10. Gargle your mouth and throat with water.

Spiriva® HandiHaler® is a once-daily inhaled medicine used to treat Chronic Obstructive Pulmonary Disease (COPD). It is also called by its generic name, tiotropium. Spiriva is a controller medicine and should be used daily as prescribed by your healthcare provider.

Tudorza™ Pressair™ is a prescription medicine used long term, 2 times each day to treat symptoms of Chronic Obstructive Pulmonary Disease (COPD), including chronic bronchitis and emphysema. It is not a rescue medicine and should not be used to treat sudden breathing problems.

Using your Turdoza™ Pressair™ (aclidinium)

1. Remove the green protective cap by lightly squeezing the arrows marked on each side.
2. Hold the Pressair inhaler with the mouthpiece facing you. The green button should be facing straight up.
3. Before you put the inhaler in your mouth, press the green button all the way.
4. Release the green button – DO NOT continue to hold the green button down.
5. Check the Control Window to make sure your dose is ready for inhalation. The green control window tells you that your medicine is ready for inhalation. If the control window is red, repeat steps #3 and 4.
6. Breathe OUT fully and away from the device. Don’t take a breath until step #7.
7. Put the device in your mouth with lips tight around the mouthpiece.
8. Breathe IN quickly and deeply to fill your lungs full of medicine. Continue breathing in after you hear a “click” sound.
9. Hold your breath for 5 seconds and then take the device out of your mouth. We want to keep your lungs filled with medicine for 5 seconds.
10. Breathe IN and OUT normally.
11. Check for the red control window to make you inhaled the full dose of medication. If the green control window is present, repeat steps #8–10.
12. Replace the green cap back onto the Pressair inhaler.