How to use inhaler devices - Part 2

Posted by Pharmacist Duong Thu Huong - Pharmacist of Vinmec Times City International Hospital

Drugs used in the form of inhalations are quite common in the treatment of respiratory diseases. Depending on the situation, each patient and the goal of treatment, the doctor will prescribe different drugs. However, the general rule is always to use the inhaler correctly, providing maximum treatment effectiveness and limiting drug waste as well as unwanted side effects.

3.1 DPI Dry Powder Inhalers There are many types of dry powder inhalers and their uses will vary slightly. Basically, after activating the device and the medicine is ready, the method of drug delivery is as follows:
Inhale and exhale normally Close your mouth on the mouthpiece, inhale deeply and forcefully then hold your breath. 5-10s or as long as possible. Remove the tool from the mouth, exhale. Do not breathe while holding the device in order to avoid wetting the instrument The method of activating the instruments is detailed below:
a) Accuhaler (circular disc shape)/Ellipta (flat flower bud shape) Mouth opening latch by pushing the lid aside.
For Accuhaler, slide the lever down until you hear a click. For Ellipta: Open the lid until you hear a click, the device is ready to inhale Note: If you close and open the lid or push the lever without inhaling, the user will lose 1 dose. Ellipta has a shelf life of 6 weeks after opening. Check the dose counting window. If you hear a click but the window does not jump, the drug has not been activated. The above steps need to be repeated until the dose counting window jumps
b) Turbuhaler/Twisthaler form (cylindrical) For Turbuhaler: Open the mouthpiece cover. Turn the bottom of the cog to the right and then to the left until you hear a click.
For Twisthaler: After turning the cap on, you will hear a click, meaning the drug has been loaded, no need to turn it any more.
c) Handihaler (flat egg shape)/Breezhaler (flat box shape) form Because the drug is not available in the device, it is necessary to remove the medicine from the aluminum blister and use it immediately. Note: Capsules are not intended for swallowing! Place the drug capsule in the medicine chamber in the device. Reseal Press the button on the side of the device until you hear a click (the sound of the capsule shell being punctured). No need to press repeatedly With the breezhaler: when inhaling the user will hear a murmur because the capsule rotates in the chamber. If no sound is heard, the chamber should be reopened and patted to prevent the capsule from sticking to the chamber. Multiple inhalations can be made until the capsule is empty. Once finished, remove the applicator and discard the used capsule d) RespiClick form Make sure the cap is tightly closed before use Keep the instrument upright and Open the cap until you hear a click, then the device is activated e) Pressair inhaler Remove the cap by gently squeezing the arrows on each side of the blue cap Hold the instrument with the blue button facing up Before putting it in mouth, push the blue button all the way, then release it. Look in the small window on the mouthpiece to see if it changes color from red to blue. If the color has not changed, press again until the color turns green, indicating the active tool. General note for dry powder inhalers:
Do not wash pre-filled dry inhalers with water. The mouthpiece can be cleaned with a dry cloth Some powders are very sensitive to moisture. It is necessary to keep the instrument in a dry, low-humidity place to avoid reducing the effectiveness of the drug. Note the common mistakes when using a propellant inhaler:
Inhalation is not enough force Do not inhale quickly and deeply Note : Lactose powder inhalers – talk to your doctor in case of a milk allergy will run out of medicine. If not, the user should keep a log of the number of times the device is used to know when the device will run out of medicine

4.2 Fine granular inhaler Attach the pressure chamber containing the medication to the body of the device for the first use. Push in the safety lock to remove the plastic body. Press the small end of the medication container into the sprayer until you hear a click. You can press down on a table or hard surface to ensure that the tip goes all the way into the tool. Do not remove the pressure chamber part outside the body after it is plugged in. Do not remove the plastic body. If the user needs help with the first installation, ask the Pharmacist for advice on how to install the tool.
Spray the tool for the first time: place the tool upright, turn the inner body to the right (clockwise) until you hear a click. Open the cap and point the mouthpiece to the floor. Press the buttons on both sides until you see the dewdrops flying out. Repeat 3 times. If not used for more than 3 days, spray the primer once again; if not used for more than 3 weeks: spray again 4 times Hold the tool with 1 hand, with the other hand, turn the transparent body to the right until you hear a click Open mouth, exhale slowly Place the mouthpiece in the mouth in horizontal direction, close tightly When starting to inhale slowly, push the button to release the medicine. Hold the breath for 10s Remove the applicator and exhale Clean the device: once a week by wiping the inside and outside of the mouthpiece with a clean damp cloth
Beware of common mistakes when using a disposable inhaler propellant : Failure to prepare medication properly Do not inhale slowly and deeply Do not hold breath How to tell when the device is out of medication: Instrument has a dose counter window on the body. When the arrow indicates “0”, the user will no longer be able to twist the body of the tool.
If you have any questions about how to use inhaler devices, you can contact Vinmec hospital for advice from a Pharmacist/Doctor on proper use.