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| |    Asthma Treatment: Proper Use of Metered Dose Inhalers by Laura Jana, M.D., F.A.A.P. reviewed by Lynn Cates, M.D., F.A.A.P. Metered dose inhalers (MDIs) are commonly used to treat asthma as well as a number of other conditions. MDIs are convenient to have on hand and don't require mixing, machinery, or special storage; however, in order to be effective, they must be used correctly. The ultimate goal when using an MDI is to truly inhale the delivered mist of medicine into the lungs, instead of simply spraying the medication on the back of the throat, only to have it end up in the stomach. Various tips on how to properly use a metered dose inhaler follow (several of which have been summarized from information provided by the American Academy of Allergy, Asthma, and Immunology, www.aaaai.org). Make sure the MDI is age appropriate. If your infant or child is too young to inhale "on demand" or to follow simple directions, they're not going to be able to use and benefit from an inhaler. Others won't be able to use an MDI properly unless an appropriate spacer is used (see below). Get a demonstration. Just like most other medications, inhalers come with written instructions, but nothing is more helpful than seeing your child's healthcare provider or pharmacist actually demonstrate how to use it. This way, a professional will know that you'll be able to make sure that your child is using the inhaler effectively. Shake the inhaler well before each use in order to mix the contents of the inhaler. Breathe out first. It's important to breathe out through the mouth before inhaling. The more room the lungs have to expand, the more medicine that can be inhaled into them. Use spacers properly. Spacers and holding chambers come in various shapes and sizes, but all are designed to increase the amount of medication that can be inhaled into the lungs. The use of a spacer or holding chamber is highly recommended, although medications occasionally can be taken without one. Position the inhaler correctly. If, for some reason, your child is not using a spacer, the inhaler should not actually be put in his mouth, but held an inch or two away from it. Breathe in effectively. Not only is it important to take a slow, deep breath to allow the medicine to be inhaled into the lungs, but it is also useful for your child to hold his breath for 5 to 10 seconds afterward to allow the medicine to settle in his lungs. Rinse after use. If your child is using a steroid inhaler, having him gargle and rinse out his mouth with water or brush his teeth after each use can help limit the potential for steroid-related side effects in the mouth (such as thrush, a yeast infection) and limit how much is actually absorbed into the bloodstream. Note the number of inhalations per MDI. Many people believe that you can tell if an inhaler is empty by putting it in water and waiting to see if it floats. Unfortunately, this is not an accurate method for determining if there is any medication left inside. Instead, you or your child should keep track of how many inhalations have been used and throw the inhaler away after you reach the recommended number.
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