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Devices

Inhalers

Most asthma medicines are given in the form of an inhaler. It is important you use your inhaler correctly so that the medicine goes straight to the airways of your lungs where it is most needed. Your doctor, nurse or pharmacist will help choose the best inhaler device for you and show you how to use it correctly.

There are three mains groups of inhalers:

  • Aerosol inhalers, also called metered dose inhalers (MDIs) or puffers
  • Breath-actuated inhalers (BAIs)
  • Dry powder inhalers (DPIs)

MDIs / aerosol inhalers:

These are the most commonly used types of inhaler device. They are small and will usually fit inside your pocket or handbag, and are used for a wide variety of drugs. Aerosol inhalers deliver the medication as a "mist" or spray and need good co-ordination to be used properly. They are not suitable for young children or adults with poor co-ordination.

They are easier to use and more effective if used with a spacer (see section below on Spacer devices).

An aerosol inhaler used with a spacer is likely to get more medicine into your lungs than using just an inhaler on its own. The spacer traps the medicine inside until you breathe in so you do not have to worry about pressing the inhaler and breathing in at the same time.

BAIs:

These are similar to aerosol inhalers,they are small and convenient to carry around. Their design helps to overcome the problems of co-ordination and so makes them a possible choice for children over the age of five years. On breathing in, the inhaler automatically delivers one dose of the medication. They are not designed for use with a spacer.

DPIs:

This type of inhaler delivers the asthma medication in the form of a dry powder. It requires users to breathe in fairly hard to get dry powder medication into the airways.To prevent your inhaler from exposure to moisture, it is very important you store it in a cool, dry area.

Inhaler use

It is extremely important that you understand exactly how to use your inhaler correctly. Using your inhaler incorrectly will stop you enjoying the full benefit of your prescribed asthma medication.

Make an appointment to see your GP or Practice Nurse if you are unsure how to use your device and ask them for a demonstration. Don't be afraid to ask them to repeat the demonstration if you are still unsure - they would much prefer to show you the technique than to treat you in future for an asthma attack or worsening conditions that could have been avoided.

Some key tips for using your inhaler effectively include:

  • Sitting up straight or standing when using your inhaler
  • Lifting your chin up to open the airways
  • Breathing out gently as far as you comfortably can
  • Inhaling quickly and deeply, as this will increase the amount of medication to your lungs

Spacer

A spacer is a large plastic container, usually in two halves that click together. At one end there is a mouthpiece and at the other a hole for the aerosol inhaler to fit in.Using a spacer with your inhaler can help increase the amount of medicine that gets into your lungs. They are normally effective in children aged 5 years or above, but you can refer to guidance on using a spacer with a baby or a child under 5 years.

There are different sizes and shapes of spacers (e.g. Volumatic, Nebuhaler, Fisonair, and Aerochamber) and your GP or Practice Nurse will help select the device best suited to your needs.

An inhaler may look easy to use, but it can take practice to get the most out of it.If you are a parent of a child with asthma, please follow the steps outlined below on how to use an inhaler with spacer properly.

To use an inhaler with spacer, follow these steps:

  1. Remove the cap on the inhaler.
  2. Shake the inhaler to mix up the medicine. Attach it to the spacer.
  3. Stand up straight, tilting the head back slightly.
  4. Breathe out slowly and forcely before using the inhaler.
  5. Press down on the inhaler. This will put one puff of the medicine into the holding chamber.
  6. Immediately place the mouthpiece of the spacer in your mouth forming a tight seal. Inhale slowly.
  7. Hold your breath for 10 seconds to allow the medicine to reach far into the lungs. If the prescribed dose is more than one puff, wait one minute between puffs and repeat the above steps. Shake the inhaler well before each puff.
  8. When finished, remove the inhaler from the spacer and replace the protective cap.
  9. Rinse your mouth with water and spit out (not swallow) the water. This helps prevent dry throat and mouth, and relieves any unpleasant aftertaste.
It is important to rinse your inhaler mouthpiece, cap and spacer once a day with warm water to prevent it from clogging and not working well. After rinsing, allow the spacer to drip dry. Do not use a towel that will leave lint in the spacer. Spacer devices should be replaced every 6-12 months.