–Introduction Music Plays– Like all of the DPIs, the Flexhaler requires significant inspiratory force and patient effort, therefore it should be inhaled with a quick, deep breath to deliver the medication appropriately to the lungs. Let’s watch as Casey describes and demonstrates how to use the Flexhaler to Mrs. Ryan. Hello, Mrs. Ryan. Hi. I’m Casey. I’m here today to show you how to use a new inhaler device. Ok. This one is called a Flexhaler. The Flexhaler has Budesonide in it. Budesonide is an inhaled steroid, a cortical steroid, to help decrease the inflammation in your lungs. Now how many doses you’ll take depends on what your clinician prescribes, so you do it according to their prescription. I see. So let me show you how to use the Flexhaler device. The first thing you do is hold it on the brown base, then you twist off the dust cap, twist it counterclockwise, then set that down. Now what you’re going to do is hold the left hand on the device, or either way, whichever hand you like, you’re going to twist the brown base. You’re going to twist it one direction till it clicks, and back, and now that has loaded the medication. Ok. Since it’s loaded the medication you don’t want to be shaking it or moving it, you want to keep it upright. Now you’re ready to inhale the medication, and when we do that we’re going to use the patient trainer. The patient trainer is to help you to know that this requires a big, deep, sharp inhalation; so you’re going to want to take a big, sharp, deep breath. This helps remind you that’s what you need to do, and it will make a whistling noise to let you know that you do it correctly. Ok. Now, luckily your medication doesn’t give the whistling noise, but just the trainer. Ok. So exhale away from the device because you don’t want to breathe in to it to gum up the medicine. So I don’t want to gum it up by breathing into the device, so exhale away, inhale sharp, deep inhalation, hold your breath for 10 seconds and then exhale. I’m glad mine won’t make that whistling sound. Definitely. Now to care for it all you do is wipe off the top with a dry cloth, not to put it in the water, because it’s a dry powder inhaler. Right. Then in the side you’ll see a little window. The little window has a counter in it. Now the counter just goes down in tens, not individual doses, so you may not even see it move much, but you are getting the medication, you are. Now, it’ll have a hash mark, or a number, so that’s showing you it’s counting down in tens. The last 10 are in red, so you can see that through your window, you see the red counting. Right, right. So that’s just to let you know as soon as the red is down to 0, time for a new device. Ok. So you put the dust cap back on, twist it back on. Lastly, since this is an inhaled steroid, you want to rinse your mouth out with water. So you rinse your mouth out with water, and spit. Make sure you don’t swallow the water because you want to get this medication off your tongue and the back of the throat. Ok. So now do you want to show me how to use this device? Sure. And then I load it this way, it clicked. Excellent. Now you want me to do the device with the whistle? Yes. Ok. Excellent. Ok, and then I can either wipe it off if I needed to, and I’m ready for the next time. Good. And now how many times do I use it, or do I need to ask my clinician that? Yes, they’ll let you know how many doses that they wish for you to take a day. Ok. Any questions? I don’t think so, thanks. You’re welcome.