Asthma, COPD - Inhaler Techniques for Counseling

UWorld Pulmonary

MDIs:

• HFA

• Respimat

• Aerosphere

• no suffix

• liquid aerosolized

• slow deep inhale

• yes prime

• yes spacer

  • hand-breath coordination needed → children, elders w/ dexterity issues, and MDI ICS users at risk for thrush can use spacer

• yes shake* (except Respimats, Alvesco, QVAR, Atrovent HFA)

  • 5 sec before each dose

DPIs:

• Diskus

• Ellipta

• Pressair

• HandiHaler

• RespiClick

• Flexhaler

• Dry Power Inhaler

• no shake/tilt

• no prime

• no spacer

• do not blow into the inhaler (고개 돌려서 exhale)

• Quick, Forceful inhale 흡!!

• cleaning도 별로 안함 “dry” cloth/wipes.

Inhaler Technique in general:

• hold breath for 10 sec

• ICS - rinse mouth with water and spit out to prevent thrush

HFA

• HFA = propellant

• albuterol HFA (ventolin, proair) → can clean mouthpiece with water, weekly

• ICS HFA (symbicort, breyna, dulera) → don’t put into water. DRY cloth.

*Atorvent HFA (특이)

• No need to shake

• Close your eyes when inhaling to prevent medication spraying into your eyes

*Respimat (얘도 특이)

• No need to shake

• TOP

  • T - Turn

  • O - Open

  • P - Press

• Prime - 뒤집어서 spray visible 할때까지 + 3번 더

• clean with damp cloth weekly

Diskus

• hold horizontally flat, do not tilt or shake

Flexhaler

• hold up right

  • 약간 FLEX~ 샷잔 chug 하는 모양

• twist the brown base fully in → one direction AND THEN ← back in other direction to hear “click”

• *얘는 prime 처음에 1번 해야되는 DPI였음

• wipe w/ dry tissue weekly

RespiClick

• 뚜껑여는 순간 “Click” = dose counted

• opening and closing the cap w/o inhaling the dose will waste medication & damage the inhaler ☹

HandiHaler (Spiriva)

• capsule crushed inside the inhaler

• open by pressing green button

• DO NOT swallow the capsule — insert it into the chamber

• green button will pierce the capsule

• should hear rattle sound from the capsule

• MUST inhale TWICE from each capsule to get full dose

Pressair

• control window should change from red → green when read to use

• → back to red if it’s used correctly

Ellipta

• 얘도 뚜껑 여는순간 "딸깍”. “Click” = dose counted.

  • dose will be lost if not used, but won’t charge? multiple doses even if you open twice.

• Do NOT block the air vent