Take Your Medicine—By Breathing It In!
Your doctor has given you an inhaler or a nebulizer to deliver your asthma medication to your lungs. Some asthma medications delivered in this way are controller medications and others are reliever or rescue medications. Controller medications keep your asthma from flaring up. Reliever or rescue medications treat an active asthma episode.
For many people, using an inhaler may be too difficult. If so, the doctor may recommend a nebulizer or spacer device. Until recently, it was not possible to treat children with corticosteroids using a nebulizer. Now, budesonide inhalation suspension medication is available in pediatric dosages.
Look for your device in the four sets of instructions below. Your pharmacist can tell you if instructions for your device are different from those presented here.
All four devices described in this brochure must be cleaned after each use following the manufacturer’s instructions. All should be stored at room temperature.
Using a Press-and-Breathe Metered-Dose Inhaler
Step 1. Remove the mouthpiece cover and shake the inhaler well (30 to 60 seconds).
Step 2. Look inside the mouthpiece or spacer (if your device has either) to make sure there are no foreign objects.
Step 3. Position the inhaler. Depending on the way your inhaler is made, you will position the inhaler in one of these three ways:
- Hold the inhaler two finger-widths in front of your open mouth.
OR
- If your inhaler comes with a spacer, attach the spacer to the inhaler and place the end of the spacer in your mouth.
OR
- If your inhaler comes with a mouthpiece, place the inhaler mouthpiece in your mouth past your teeth and above your tongue. Close your lips tightly around the mouthpiece.
Step 4. Tilt your head back slightly and breathe out gently.
Step 5. Press the inhaler as you start to take in a slow, deep breath. Take in as much air as possible. Use a spacer if you have trouble breathing at the right time.
Step 6. Hold your breath to the count of 10. If you can’t hold your breath that long, hold it as long as possible.
Step 7. Remove the inhaler. Breathe out as slowly as possible. If a second dose is needed, wait at least 1 minute and repeat steps 3 through 7.
Step 8. If your medication is a corticosteroid, rinse your mouth with water after using your inhaler.
Using a Breath-Actuated Metered-Dose Inhaler
Step 1. Remove the protective mouthpiece by pulling down the lip on the back cover.
Step 2. Hold the inhaler upright and push the lever up. NOTE: The lever must be pushed up before each dose and down again afterward. Otherwise the inhaler won’t work.
Step 3. Shake the inhaler.
Step 4. Breathe out gently. Keep the inhaler upright. Put the mouthpiece in your mouth and close your lips around it. Do not block the air vents at the bottom of the inhaler.
Step 5. Breathe in quickly through your mouth. Don’t stop breathing when the inhaler clicks—continue taking a deep breath.
Step 6. Hold your breath to the count of 10. If you can’t hold your breath that long, hold it as long as possible.
Step 7. While holding the inhaler upright, push the lever down. If a second dose is needed, wait 1 minute and repeat steps 2 through 7.
Using a Dry-Powder Inhaler
Three actions are required for a typical dry-powder inhaler: priming, loading, and inhaling. The instructions given here are for a Turbuhaler (budesonide) dry-powder inhaler. Ask your pharmacist if your inhaler works the same way.
When your dry-powder inhaler is new, PRIME it using this procedure:
Step 1. Turn the cover and lift it off.
Step 2. Hold the inhaler upright (with the mouthpiece up).
Step 3. Twist the brown grip fully to the right and back again fully to the left. You will not have to prime your dry-powder inhaler at any other time after this, even if you don’t use it for a long period.
LOAD a dose in your dry-powder inhaler using this procedure:
Step 1. Turn the cover and lift it off.
Step 2. Hold the inhaler upright (with the mouthpiece up).
Step 3. Twist the brown grip fully to the right and back again fully to the left. You will hear a click.
The dose is now loaded. Do not shake the inhaler after the dose has been loaded.
INHALE a dose from your dry-powder inhaler using this procedure:
Step 1. Turn your head away from the inhaler and breathe out. Do not blow or exhale into the inhaler.
Step 2. Hold the inhaler upright (with the mouthpiece up) or in a horizontal position. Do not turn the inhaler upside down.
Step 3. Place the mouthpiece between your lips and inhale deeply and forcefully. If you need an additional dose, wait 1 minute and follow the three steps to load a dose and these three steps to inhale a dose. You may not taste or feel the medication being delivered.
Step 4. Put the cover back on the inhaler. Rinse your mouth with water and gargle but do not swallow.
Using a Nebulizer
Step 1. Check the manufacturer’s directions regarding the cleaning of the mouthpiece, adapter, medicine cup, and the tube.
Step 2. Hold the cup upright and pour or drop in the solution your doctor ordered. (You’ll use a medication that comes to you packaged in individual doses.) Connect the cup with the lid. Do not lay the cup, lid, or mouthpiece on its side.
Step 3. Hold the medicine cup upright and the mouthpiece near your mouth, and turn on the compressor. Check for a fine mist.
Step 4. Place the mouthpiece in your mouth, making a tight seal with your lips. (Some nebulizers come with a face mask to make the device easier to give nebulized medication to young children and infants. Place the mask over the child’s nose and mouth assuring a good seal is achieved.) The nebulizer must be upright to nebulize the medication. Sit as upright as possible.
Step 5. Start breathing through your mouth, not through your nose. Be sure to take normal breaths. (Children using a face mask nebulizer may breathe through both nose and mouth.)
Step 6. About every 10 to 15 breaths, take a deep breath and hold it to the count of 5 or 10.
Step 7. Always breathe out through your mouth into the mouthpiece.
Step 8. Continue steps 1 through 7 until all the solution has been used and there is no more mist in the mouthpiece.
Check in With Your Doctor and Pharmacist
At your regular office visit, show your doctor how you typically use your inhaler or nebulizer. Or when you are at your pharmacy, talk with your pharmacist. Ask if you’re using the best technique to deliver your medicine. Review with your doctor when to use your inhaler or nebulizer. Be sure you know the names of your medications, what to expect from their use, and possible side effects.
More Information
These Web sites contain useful information on using inhalers or nebulizers:
www.respuleskids.com or www.pulmicortrespules.com
Or you can call AstraZeneca at 1-800-237-8898 for more information about using inhalers or nebulizers.
