Priming and Cleaning Your Metered Dose Inhaler

Metered-dose inhalers (MDIs) are devices that deliver medication directly into your lungs, including relief medications such as albuterol or Proventil, and maintenance medications such as Flovent or QVAR. Used correctly, an MDI inhaler helps control symptoms so you can breathe easier.

Correct Usage

Using an MDI correctly is an important part of any treatment plan. Incorrect usage can lead to receiving less medication or no medication at all, which negatively impacts your symptoms.

If you’re not sure that you’re using your MDI correctly, or you need a refresher, be sure to read: How to Correctly Use a Metered-Dose Inhaler With and Without a Spacer.

Priming the MDI

Your MDI consists of a canister that holds the medication and a plastic mouthpiece that houses the canister. Before using it, or if it hasn’t been used in two weeks or more, it needs to be prepared, or primed.

Although each inhaler comes with a specific set of instructions provided by the manufacturer, the following are general instructions for priming:

• Insert the canister into the mouthpiece.
• Shake vigorously for five seconds.
• Press down on the canister with your index finger while holding it away from your face to release the medication into the air. Repeat this step 3 more times.

Cleaning the MDI

To get the most out of your MDI, it should be cleaned at least once per week to prevent medication buildup that may block the medication from being delivered properly. To clean your inhaler:

• Remove the cap and the medication canister from the mouthpiece. Avoid washing the canister or immersing it in water.
• Run warm water through the top and bottom of the mouthpiece for 30 to 60 seconds.
• Shake excess water from the mouthpiece before allowing it to air dry, preferably overnight.
• If you need to use the MDI before it’s completely dry, shake off excess water, place the canister in the mouthpiece, and test spray first by pressing down on the canister two times (away from the face).

Cleaning the Spacer

A spacer is a plastic, tube-like chamber that temporarily holds the medication released from the canister, allowing you to inhale slowly and deeply, one or two times. Spacers are used for several reasons: to decrease the amount of medication deposited on the tongue or back of the throat, to allow more medication to reach the lungs, to allow for better timing of your inhalation with the spray of the medication.

To ensure you’re getting the right dose, proper technique and regular cleaning is necessary.  Be sure to read the manufacturer’s instruction before using your spacer.

Below are general guidelines for cleaning:

• Using warm water and dishwashing soap, wash your spacer every one or two weeks as recommended by the manufacturer. Avoid washing with water alone as this may reduce the spacer’s efficiency.
• After a thorough rinse, allow your spacer to air dry before using it again.

If You’re Still Having Trouble

If you have difficulty using your inhaler, with or without a spacer, ask your doctor to review the steps with you at your next appointment. Be sure to perform a return demonstration before leaving the office to ensure you’ve understood the instructions.

_Source:

_{Bailey, William, MD., Gerald, Lynn B., PhD, MSPH. “Patient information: Asthma inhaler techniques in adults (Beyond the Basics.)” Wolters Kluwer Health. Up to Date. Updated November 5, 2013.}

by Deborah Leader RN, BSN, PHN