How do you use a dry powder inhaler for asthma?

How to use a discus dry powder inhaler. Check the dose counter on the side of the inhaler. Do not use if it says zero zeromeans the inhaler is empty and needs to be replaced with one hand. Hold the discus in a level flat position and open it with the other hand. Place your thumb on the thumb grip. Push your thumb away from you until it clicks. You should now see the mouthpiece while holding the device in a level flat position. Use your thumb again to push the dose lever away from the mouthpiece as far as it will go until you hear it, click. 

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Prepare your body by sitting or standing up straight. Breathe out all the way away from the inhaler. Never breathe into the device. Tilt your head back slightly. Put the mouthpiece into your mouth between your teeth. Close your lips tightly around the mouthpiece. Breathing quickly and deeply through your mouth. Remove discus from your mouth and hold your breath for up to 10 seconds.

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Breathe out slowly away from the device. 

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Rinse your mouth out with water and spit it out. 

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Close inhaler cover until it clicks and store in a cool dry place. If you have trouble using the inhaler correctly, ask your pharmacist or doctor for help.

Some Kiwis also use the Accuhaler, which is also a breath activated device. Doses of the medicine are set into a foil strip inside the Accuhaler.

What is the Turbuhaler?

The Turbuhaler is most common dry powder inhaler used in New Zealand. It has no propellant or carrier added to the medicine. You will hardly notice any powder in your mouth. The recommended age of use is 12 years through to adult.

Using your turbuhaler

  1. Unscrew and remove the cap
  2. Hold the Turbuhaler upright. Turn the grip as far as it will go and then back to the original position – listen for the click. (Repeating will not double the dose)
  3. Sit upright, and breathe out gently
  4. Insert the mouthpiece into the mouth holding the inhaler horizontally ensuring that the lips are firmly sealed
  5. Breathe in steadily and deeply
  6. Remove the Turbuhaler from the mouth, then breathe out gently through the nose
  7. Replace the cap securely
  8. Rinse mouth and spit out or clean teeth after using a corticosteroid preventer

There is a window under the mouthpiece on the outside of the Turbuhaler called the ‘Empty Soon Indicator.’ When a red mark or a number appears at the top of the window, there are approximately 20 doses left.

Some common mistakes when using the turbuhaler are:

Not holding the inhaler upright when priming

  • Covering the air inlets with lips
  • Breathing in through the nose instead of the mouth
  • Shaking the inhaler to see how much is left
  • Storing inhaler in a damp environment with the cap off

Using your Accuhaler

  1. Open the device by holding the outer case. Using the thumb grip, slide the cover open as far as it will go
  2. Face the mouthpiece towards the person using the device
  3. Push the lever away from the mouthpiece until you hear the ‘click’
  4. Sit upright, tilting the head back (as if you are sniffing – ‘sniff’ position) and breathe out gently
  5. Insert the mouthpiece into the mouth ensuring that your lips firmly seal the mouthpiece
  6. Breathe in fully, remove Accuhaler from the mouth and hold breath for 10 seconds or as long as is comfortable
  7. Breathe out gently through the nose
  8. Slide the thumb grip back over the mouthpiece
  9. Repeat if second dose required
  10. Rinse mouth and spit out or clean teeth after using a corticosteroid preventer

Some common mistakes are exhaling into the device, breathing in through your nose instead of your mouth, or not ‘clicking’ the lever after opening the cover.

You will know that it is time for a new inhaler when the number of doses remaining is displayed (with the last five numbers in red.)

Your provider may have prescribed your asthma medicine to be administered using a hand-held device called a dry powder inhaler (DPI). Here's how to use your Diskus® brand inhaler.

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How do you use a dry powder inhaler for asthma?

What is a dry powder inhaler (DPI)?

Some asthma medications can be taken in the form of a dry powder using a small, hand-held device called a dry powder inhaler (DPI). DPIs deliver medication to the lungs as you inhale through the device. The DPI doesn’t push the medication into your lungs. You have to breathe in strong and steady to get the medicine.

What is the Diskus® DPI?

The Diskus® (Figure 1) contains 60 doses of medication (brand names are Advair®, Flovent®, or Serevent®). It has a dose counter that automatically counts down the number of doses as you use them. Doses 5 through 0 are in red to alert you to refill your prescription.

When the counter reads “0”, there is no medicine left in the Diskus. Throw away the empty Diskus and begin using a new one.

How do I inhale my medication?

  1. To load a dose, hold the Diskus in your left hand. Place your right thumb in the thumb grip. Push your thumb as far away from you as it will go. This action opens the Diskus to expose the lever underneath.
  2. Hold the Diskus in a level, flat position. Slide the lever away from you until it clicks. This action loads the dose of medication. You will see the dose counter decrease by one.
  3. Turn your head away from the Diskus and breathe out as much air as you comfortably can.
  4. Place the Diskus mouthpiece in your mouth, breathe in strong and steady, but not too fast, and completely fill your lungs.
  5. Hold your breath for 10 seconds.
  6. Remove the Diskus from your mouth and exhale slowly. Wipe off the mouthpiece.
  7. Close the Diskus by placing your thumb in the thumb grip and sliding the grip back toward you as far as it will go. This action resets the inhaler so it is ready to use for the next dose.
  8. If more than one dose is prescribed, repeat the previous steps.
  9. If the Diskus contains a steroid, rinse your mouth and gargle (do not swallow), then spit.

How do I care for my Diskus?

  • Keep your Diskus in a dry place at room temperature.
  • Never place the Diskus in water.
  • Never shake or breathe into the Diskus.
  • Never use a spacer device/holding chamber with the Diskus.

Unlike other inhaled medications, you may not taste or feel the dry powder or there may be a slightly sweet taste. This experience may be different from what you're used to. As long as you follow the directions, you'll get your full dose of medication.

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Last reviewed by a Cleveland Clinic medical professional on 12/21/2020.

References

  • American Association for Respiratory Care. Guide to Aerosol Delivery Devices (http://www.aarc.org/wp-content/uploads/2015/04/aerosol_guide_rt.pdf) Accessed 4/20/2021.
  • American Thoracic Society. Using Your Metered Dose Inhaler. (https://www.thoracic.org/patients/patient-resources/resources/metered-dose-inhaler-mdi.pdf) Accessed 4/20/2021.
  • American Academy of Allergy, Asthma & Immunology. Dry Powder Inhaler (http://www.aaaai.org/conditions-and-treatments/conditions-dictionary/dry-powder-inhalers.aspx) Accessed 4/20/2021.
  • Asthma and Allergy Foundation of America. Dry Powder Inhalers (http://www.aafa.org/display.cfm?id=8&sub=17&cont=167) Accessed 4/20/2021.

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Should dry powder inhalers be shaken before use?

Some people forget to shake their inhaler before using it. Inhalers such as MDIs need shaking before using to ensure the medicine and propellant mix properly, but other inhalers may not need shaking.

What is a dry powder inhaler for asthma?

A dry powdered inhaler (DPI) is an asthma treatment option for older kids and teens. Using a dry powdered inhaler allows medicine to get deep into the lungs. Unlike other inhalers which deliver a puff of medicine, these inhalers hold the medicine as a dry powder.

Is a dry powder inhaler better?

Dry powder inhalers (DPI's) in general are easier to use than the MDI and cause fewer irritant effects. Unlike the MDI few patients develop a poor inhalation technique with continued use of DPI's. Comparisons of multidose DPI's have shown that they achieve a similar degree of bronchodilatation to the MDI.