Patient was educated on how to use Qvar aerosol inhaler as follows:

  1. Always, check the expiration date on the Qvar inhaler before using it.
  2. Shake the inhaler well for 5 seconds before every use.
  3. Take the cap off the mouthpiece.
  4. Make sure the mouthpiece is clean before having it in the mouth.
  5. Hold the Qvar inhaler between the thumb at the base and the index finger at the top, with the canister up and mouthpiece down. The mouthpiece of inhaler should face you.
  6. Perform a normal quiet breathing in and then, breath out normally away from the inhaler.
  7. Bring the inhaler to your mouth and place the mouthpiece in between the teeth with the chin up a little. This position of the chin will help better deposition of the medication into the airways.
  8. Make sure the tongue is not obstructing the mouthpiece, by having the mouthpiece over the tongue and not under.
  9. Close the mouth tightly around the mouthpiece.
  10. Breathe in slow and deep for a complete breath, for a count of 5 seconds. At the same time, activate the Qvar inhaler by pressing the top of the inhaler with the index finger. Performing both these acts at the same time is a task that will help delivery of the medication to the site of action in the airways and lungs. You can use the spacer, if you have difficulty coordinating these activities.
  11. Withdraw the mouthpiece from your mouth and breathe out slowly.
  12. One activation of the Qvar inhaler counts for one puff.
  13. Hold breath for 5 to 10 seconds giving time for the medication to be deposited into the airways, for it to act.
  14. If you are ordered to have two puffs as your dose, wait for a minute before taking the second puff.
  15. For the second puff, start with shaking the Qvar inhaler for 5 seconds and repeating all the steps of the procedure throughout.
  16. Replace the cap on the mouthpiece of Qvar inhaler, once you completed intake of your prescribed dose.
  17. Gargle and rinse the mouth with water after every dose of Qvar inhalation. Spit out this water after rinsing and do not swallow. This helps prevent opportunistic candida infection in the oral cavity.
  18. Compliance with the use of Qvar inhalations as ordered, at regularly spaced intervals, is very important to control the inflammation of the respiratory tract and prevent any exacerbation of asthma and COPD attacks.
  19. Do not overdose on the use of Qvar inhalations, as it can significantly increase the chances of side effects of steroid use.