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Get the Most from your Prescribed Inhaled Medications

by Melaine Giordano, MS, RN, CPFT Content Editor

September 8 , 2006

The American Association for Respiratory Care wants you to understand and use your inhaler properly so that your asthma, COPD, or other respiratory condition can be properly managed and you can get the maximum and intended benefit from your prescription.

Here are important things to know about using an inhaled medication.

Use your MDI properly.

It takes a good technique to ensure that the medicine dispensed through your Metered Dose Inhaler (MDI) makes it into your airways and lungs.

  • Practice your breathing technique. This will help you learn the right methods. Demonstrate it each time you visit your doctor or respiratory therapist.
  • Use a spacer or holding chamber to disperse the medication and allow it to be inhaled in the correct manner.
  • If you do not have a spacer or holding, open your mouth and hold the MDI about an inch away from your lips. Note: the best delivery of medication occurs when you use a spacer or holding chamber and this is recommended.
  • Shake the MDI canister each time you use it to properly mix all elements.
  • Breathe out BEFORE pressing your inhaler.
  • Press down on the MDI at the start of your inhalation, then breathe in evenly and deeply.  Make sure you breathe in through your mouth, not your nose.
  • Keep inhaling as you press on the inhaler and press the inhaler ONLY ONCE.
  • Hold your breath for up to 10 seconds to allow the medicine to reach deep into the lungs, then exhale.


Use your DPI properly.

  • Take care not to exhale into your DPI. The moisture from your breath can clog the inhaler and you would get less drug as a result.
  • You do not need to shake your DPI before use.
  • Place your teeth on the mouthpiece and seal your lips around it. Make sure your tongue is not blocking the mouthpiece.
  • Breathe in quickly and deeply though your mouth. This activates the flow of medicine.
  • Remove the inhaler from your mouth and hold your breath for up to 10 seconds.
  • Some DPIs require you to put a pill or capsule into your DPI device. Please be sure that you place the capsule or pill into your inhaler and DO NOT take it by mouth.



Getting all the Medicine

Getting the appropriate amount of medicine out of an MDI is an inexact science. In an MDI there is medicine mixed with a propellent. It is important that you get medicine and not propellent alone in your dose.

  • If it has been more than 24 hours since your last dose you should “prime” the canister. Priming allows the delivered dose of medication to contain the prescribed amount of medication. Priming is essentially pumping one dose into the air.


  • Shake the MDI canister each time you use it to properly mix all elements.

Use some of these methods to assure you are getting medicine with your dose delivery.

  • Keep a diary counting the number of doses you have taken from the inhaler.
  • Purchase and use a dose meter. These are available at pharmacies.
  • Do the math! Keep an accurate count of the number of puffs you’ve taken and compare to the number of puffs stated on the inhaler literature.
  • Do not float the canister. This used to be an accepted method for gauging the amount of medicine in your inhaler, but it does not give true results.


Use your Nebulizer Properly

You may also be using a nebulizer at home to aerosolize your medicines. Here are a few tips on nebulizer use.

  • Place your medicine in the nebulizer cup.
  • A nebulizer treatment should last about 10 minutes. If it takes longer, check for a blockage in the filter.
  • If there is less mist than usual during your treatment, check for a leak, a cracked nebulizer cup, loose connection of the tubing leading to the nebulizer  or a blockage in the filter.
  • There is no special technique for a nebulizer treatment. Just breathe normally, with an occasional breath hold.
  • After the treatment, empty the cup.
  • Periodically wash the cup with soapy water and disinfect it.


Understand your Medicines

Check with your doctor and respiratory therapist on the types of medicines you are receiving and when and how you use each medicine. It’s imperative that you understand the purpose of these medications.

For asthma and COPD there are medicines that are for long-term control of your condition. These are sometimes called “maintenance” medications. They help keep your condition under control and avoid flare-ups and severe episodes.

There are also medicines that are quick-acting and provide fast relief in the event of an episode. This should make your breathing easier. They are also referred to as bronchodilators.

Learn more about these from your doctor and respiratory therapist and visit for a more detailed description.

© 2019 American Association for Respiratory Care