How to use an inhaler for asthma and COPD

By Adem Lewis / in , , , , , , , , , , , , , , /

Good morning Mr Hamilton, I’m Gavin Hunter, respiratory nurse specialist at the hospital. Thank you very much for coming along to help demonstrate how to use inhaler devices. And hopefully this will be able to demonstrate to patients, why we use certain devices for certain conditions in certain patients. Why does a patient need an inhaler? Respiratory diseases particularly COPD
and asthma, require certain types of treatments. And one of the best ways of
getting the drug into the lung is by taking an inhaler, which allows a patient to breathe in the drug into the lungs, which will make the patient’s feel a bit
better. Does everyone get the same inhaler? There are lots of different
devices on the market and lots of different medications. How do you decide which inhaler a patient should use? What we tend to do is have a discussion with the patient about the type of inhaler that will suit them. That would involve their ability to use the inhaler and not only that, also their ability to have enough breath in order to get the medication deeply into the lungs. Here are some devices that I brought along to day to demonstrate. Which are metered dose inhalers and dry
powders inhalers. What I’ll do is I’ll show you one of the dry powder devices. That are used commonly to treat patients with asthma and COPD. This particular inhaler is called a turbo inhaler and the medicine is enclosed in the chamber here at the bottom of the device. There’s a mouthpiece at the top as you can see and at the bottom there’s a little knob which turns two ways. And that’s how the medication is loaded, ready for use. Now the important part how to get the
medication into your lungs by taking a deep breath through the inhaler from empty lungs. So it’s very important that you breathe all the way out first. Until there is no air left in your lungs then put your lips tightly around the top of the inhaler and then take a deep breath in, quite quickly at the start to liberate the drug from the inhaler. Then try and hold your breath for around five seconds at least to allow the drug to get into the lungs and then you can breathe out without having the inhaler in your mouth. Now this device makes a little whistle noise that’ll let you know you’re breathing in deeply enough in order to get the medication into your lungs, as we discussed earlier. I’d like you to try and see if you can use it. You only need to load it round once,
click and back. All the way out sir. Try and take with a nice tight seal a deep
breath in. Harder. And all the way in and hold your breath. Hold for five seconds if you can and breathe out. Very good. So that device involved twisting the base of the inhaler in order to get the drug ready to use. But there are many different drug types on the market, many different inhalers on the market, so if that one wasn’t to agree with you, we can try a different device. So don’t worry, we would almost certainly find something that you would be able to use. This particular device involves sliding the side of the inhaler down in order to hear a sharp click. That lets you know that the medication is ready to inhale into your lungs. This is a metered dose inhaler, what you do with this inhaler is you remove the cap. What you have to do is remember to gently shake the inhaler before you use it, in order to liberate the medication before you squeeze it into your lung. So it’s a bit like using the other inhalers, exactly the steps again: breathe all the way out until there’s no air left in your lungs. Bring the inhaler up to your mouth and then as soon as you spray you take a deep breath in again, looking to hold for at least five seconds if you can. Then breathe out without the inhaler in your mouth. I’ll leave the cap off just now and give
you it like that. Breathe all the way out first. Then bring up your mouth and breathe through the inhaler. That’s common when you see the medication coming out in a spray like that, so no medication is getting into your lungs. That was very difficult to press it and hold it in position at the same time. Yes a lot of patients tend to say that using this device alone. But there’s a little device we can use sometimes with this inhaler that helps to improve the amount of medication we can get into your lungs. Now this is the same inhaler you used earlier, which you struggled a little bit, in order to coordinate your breath with the triggering of the inhaler. So when you’re using this device you have to shake the inhaler obviously, in order to liberate the drug. I take one spray, don’t worry that you’ll lose the medication, because there’s a rubber seal in there that prevents your drug getting out of the chamber. Breathe all the way out, like you do with all inhalers, bring it up to your mouth. That was pretty good actually. If you have to take two sprays, there needs to be around 30 seconds later, before you take the second puff. How do I know there’s enough medication left in the inhaler? Almost all inhalers come with a counter on them, which turns red when the inhaler is about to run out, which is quite useful and allowing you to reorder. However if there’s any issues with regard to the medicine and you think it might be running out, you should speak to your pharmacist, nurse or GP. Because the last thing you want is to be taken an inhaler without any medication in, because that could lead to trouble. Thanks very much for coming along today, I fairly enjoyed the talk and I hope you enjoyed helping other patients learn how to use inhalers. You’re welcome.

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