–Introduction Music Plays — Like all of the DPIs, the Handihaler requires an appropriate 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 Handihaler to Mrs. Ryan. Hello Mrs. Ryan, I’m Casey. Hi. I’m here today to show you how to use a new inhaler device. This one is called a Handihaler. Now the Handihaler has Tiotropium, which is a long-acting bronchodilator, so it’s one that opens up your airways for 24 hours. So you’ll be inhaling one capsule, once a day. So let me show you how to use this Handihaler. Now the Handihaler’s a little egg-shaped device. The first thing you do is need to open up the top. The top can either be opened like this, or you can push the green button, and that’ll help open it up, either way. Ok. Now you have the white mouthpiece. You’re going to open that mouthpiece up, so open up the device. Good. And now you see there’s a hole in the base. The hole in the base is where you’re going to be putting the capsule with the medication in it. Ok. So, now you’re going to be opening up one capsule, and you can only open up one at a time because the medication gets gummy if it’s exposed to air for a long period of time. Ok. So open up your one capsule when you’re ready, and you now place that directly in the base. Good. Ok. Now you close up the mouthpiece till it clicks. Good. Now you need to pierce the capsule so the medication can come out, so you take the green button, and you push it. Excellent, now if it’s too difficult to push the green button in, usually what I’ll say is run it into a table or a chair, something that can give you the help you need to maybe push that green button in. Ok. So now, since this is a dry powder inhaler, you don’t want to exhale or breathe into the inhaler because that will gum up the medication. So you’re going to exhale away, you’re going to take a big, deep, sharp breath; hold it for 10 seconds, and then exhale. So exhale away. Inhale. Excellent. Now if you feel you haven’t had all the medication, you can do it a second time, and usually that’s what they recommend, just do it a second time to make sure that you have all the medication inhaled. I see. Exhale. You can hear the capsule just vibrating and rolling around a little bit as you inhale, can’t you. Yeah. Now we’re going to get rid of the capsule. You’re going to open up the mouthpiece. Now since this capsule has medication in it that wouldn’t be good near your eyes, you just dump that out in the trash. So you don’t play with the capsule after you’ve inhaled it. Ok. You just close it back up. If you need to you can take a cloth and wipe it off. You don’t need to wash this, and it shouldn’t be in water, since it is using a dry powder inhalant. Ok. Close it back up and it’s ready to go for the next time. Ok. Now do you want to show me how to use it? Sure. Let’s see, open it up, open this part up so I can put the capsule in. Open up the capsule, not ahead of time, and close the top up. Good. I’m going to pierce the medication now. Good. And then I’m going to exhale. Excellent. And if I need to then I can do that a second time. Mm-hmm. And now how do you get rid of the capsule? I’m just going to open this up, I’m not going to get it near my eyes, and toss it in the trash. Excellent. Ok, I like it, pretty simple. Yes, the last thing to remember this is a capsule, but it’s not a capsule to be taken by mouth, it’s one that you use to inhale with your inhaler. Got it. So don’t be swallowing your capsules. Ok. Any questions at all? I don’t think so, Casey, thanks. You’re welcome.