Patient was instructed on the process to use metered dose inhaler as follows:
- Always, check the expiration date on the inhaler before using it.
- Shake the inhaler well for 5 seconds before every use.
- Take the cap off the mouthpiece.
- Make sure the mouthpiece is clean before having it in the mouth.
- Hold the 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.
- Perform a normal quiet breathing in and then, breath out normally away the inhaler.
- 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.
- Make sure the tongue is not obstructing the mouthpiece, by having the mouthpiece over the tongue and not under.
- Close the mouth tightly around the mouthpiece.
- Breath in slow and deep for a complete breath, for a count of 5 seconds. At the same time, activate the 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.
- One activation of the inhaler counts for one puff.
- Hold breath for 5 – 10 seconds giving time for the medication to be deposited into the airways, for it to act.
- Withdraw the mouthpiece from your mouth and breath out slowly.
- If you are ordered to have two puffs as your dose, wait for a minute before taking the second puff.
- For the second puff, start with shaking the inhaler for 5 seconds and repeating all the steps of the procedure throughout.
- Replace the cap on the mouthpiece of inhaler.
