Using a Metered-Dose Inhaler and Spacer

Metered-Dose Inhaler

Many asthma medicines come in a small metal canister that sprays the medicine into your lungs and is called a metered-dose inhaler (MDI). Some people call them "puffers". The MDI or "puffer" sprays the medicine out in the right amount for you to breathe in and you usually take one or two puffs. Between puffs you usually have to wait 30 seconds to 1 minute. Breathing in or inhaling your asthma medicines is a good way to take them because they get into your breathing tubes quickly. If you take a pill for asthma it takes longer to start working.

Here are the basic steps to use an MDI or "puffer":

1. Shake the MDI well to mix up the medicine
2. Tilt head back a little
3. Remove the cap from the mouthpiece and hold the mouthpiece in front of the mouth
4. Blow out all the way
5. Begin to breathe in slowly and at the same time press on the MDI to release one puff of medicine
6. Continue to breathe in all the way
7. Close mouth and hold breath in for 5 - 10 seconds before slowly breathing out
8. If your doctor told you to take 2 puffs, wait 30 - 60 seconds between puffs. This way, the first puff can open your airways, and the second puff can work better.

Spacers These tubes or bags are attached to the MDI and they act as a holding chamber from which the medicine can be breathed in more easily. You spray the medicine into the spacer before you breathe in and you don’t have to coordinate pressing the puffer and breathing in so precisely. You just breathe in slowly. It makes it easier for medicine to go further down your airways and work better in your lungs. Spacers also reduce gagging and spasm than can occur from the spray hitting the back of your throat.

Also spacers should be used with inhaled corticosteroids because it reduces the problems of thrush and hoarseness.

Contact Your Health Care Provider If:

• There is no relief from MDI or the relief lasts only a short time
• There is shortness of breath after using puffer bronchodilator medicine
• Medicine supply is low
• You are worried about your condition
• You have the following:
  • a fast, pounding heartbeat
  • nausea, stomach ache, diarrhea or vomiting
  • irritability and restlessness
  • trouble sleeping
  • a headache
  • muscle twitching

The Types Of Medicine That Can Be Delivered With The MDI Include:

Bronchodilators -- medicines that relax the muscles around breathing tubes and make breathing easier. They work quickly and include albuterol (Proventil and Ventolin), metaproterenol (alupent) and pirbuterol (Maxair). Salmeterol (Serevent) is a bronchodilator that is taken only twice a day and does not act as quickly as the others mentioned.

Inhaled Anti-inflammatory Medications

Corticosteroids -- medicines that decrease the inflammation and swelling in your breathing tubes such as beclomethasone (Vanceril, Beclovent), flunisolide (Aerobid) and fluticasone (Flovent).

Non-steroids -- also decrease inflammation such as cromolyn (Intal) or nedocromil (Tilade).

Resources For More Information:

Asthma Center at Long Island College Hospital

James P. Mara Center for Lung Disease at St. Luke's - Roosevelt Hospital Center

The material contained in this document was prepared to provide basic information.
Questions concerning its application to your particular case should be directed to your physician.