Payel Gupta, MD, on How to Use Your Inhaler Properly

In this video, Payel Gupta, MD, explains the proper steps to follow for using a metered-dose inhaler, including how to clean and prime the inhaler, how to breathe, and if there are differences in technique for adults and children.

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Payel Gupta, MD, is a volunteer national spokesperson for the American Lung Association affiliated with Mount Sinai Hospital and SUNY Downstate Medical Center. 


Dr Payel Gupta: This is what the metered dose inhaler looks like. A couple of important things to keep in mind is that inhalers need to be taken care of properly. There are washing instructions usually provided with the package insert for inhalers. You want to keep that in mind and make sure that you're paying attention to those things.

The first thing I always tell my patients to do is take the cap off, look at the inhaler. Make sure that there's nothing inside of the mouthpiece, so make sure that there aren't any foreign objects stuck inside there. Clean that out, obviously, if there are.

The next thing is before you use your inhaler, you want to be either sitting up straight or standing up, ideally. The reason that we want you to stand up is because it allows your airways to be able to expand for you to be able to take a nice deep breath in. That's the best position is either sitting up really straight or standing up, ideally.

Once you're in that position, a couple of things to remember also about the inhaler is that if it's been a while since you've used the inhaler, you need to prime it. If it's a new inhaler you also need to prime it.

What does priming mean? It means that you're shaking it vigorously. That essentially gets the propellant and the medication to be mixed appropriately so that when you take the inhaler you're not only taking in the propellant, you're getting the medication.

Once you shake the inhaler, then to prime it you're going to face it out, away from your face, and you're going to spray it out into the air. It's recommended when the inhaler is new to do that entire cycle of shaking and spraying the inhaler up to four to five times.

Again, all the package inserts for every inhaler will have priming instructions. You want to make sure that you follow those.

The next thing is if you haven't used it for two weeks to over two weeks, the inhaler does need to be primed again. You don't need to do it four to five times. Usually, it's recommended to do it one to two times, where you shake it and you spray it out into the air, away from your face.

Once you've done all of that and your inhaler is ready and primed, then every time before you use it, you're still going to shake it. Again, that's so that the propellant inside the inhaler is mixed appropriately with the medication and that you don't get all of the propellant inside of your airways and you get the medication, which is why we're using the inhaler.

Standing up straight or sitting up straight, you're going to shake the inhaler, take a nice deep breath out. [breathes out] You're going to put the inhaler into your mouth, and you're going to want to make sure that your tongue or your teeth are not blocking the mouthpiece.

You want to make sure your tongue is underneath and that your teeth are obviously around the mouthpiece and not blocking the mouthpiece, because then you won't be able to get the medication.

Once you do that, you're going to take a nice deep breath out, [breathes out] put it in your mouth, and then you're going to push down on this canister part. As you're pushing down, you're going to take a nice deep breath in. You're going to slowly inhale, ideally for a count of five or greater.

Once you're done doing that, you're going to take your mouth off of the mouthpiece and you're going to keep your mouth shut. You're going to hold your breath for 10 seconds, or as long as you possibly can. [holds breath] Then you take a nice deep breath out like you normally would. That's essentially how you use your metered dose inhaler.

You want to make sure that if you need to take two doses of your inhaler that you wait at least 30 seconds to 1 minute before you do the second dose.

Thank you so much for watching this video.

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