The Independent Pharmacy

Asthma Inhaler & Spacer Technique: Guide For Asthmatics

Scott McDougall
Scott McDougall
MPharm GPhC 2079324
Director & Registered Manager

For some, using inhalers can be tricky. Studies suggest that up to a third of asthma sufferers aren’t using their inhalers correctly. Ensuring you are using the correct technique is essential for receiving the full dose of medicine from your inhaler. A poor technique could result in the medicine not reaching the lungs as desired; instead, it could be hitting the back of the throat or lingering in the mouth and on the tongue. Incorrect usage will not only fail to relieve your asthma symptoms, but also could lead to further complications such as oral thrush or a sore throat.

There are many different types of asthma inhalers, with some requiring a different technique to others. Your GP or asthma nurse will be able to talk you through your options. Finding an inhaler that you find easy to use will help encourage a good technique. Below is a list of the different inhaler devices available:

Ventolin Inhaler & Accuhaler

Ventolin Inhaler & Accuhaler

Ventolin (blue) inhalers are the most widely used treatment to relieve the symptoms of wheezing and breathlessness associated with asthma.

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Spacer devices: a spacer device is typically a small plastic chamber that connects to your inhaler. It is designed to be used with metered dose inhalers that are not breath actuated. After the canister on the MDI has been pressed, the dose is released from the inhaler into the spacer device. The other end of the spacer has a mouthpiece from which the recipient of the intended dose can slowly and deeply inhale the medicine. Using a spacer device can dramatically decrease the amount of medicine deposited at the back of the throat, in the mouth, and on the tongue. A spacer will usually be recommended if the patient has difficulty timing their spray with their inhalation.

How to use your metered dose inhaler

  1. Remove the cap from the mouthpiece
  2. Check to make sure there is still medicine in the canister
  3. Shake the inhaler to properly mix the medicine with the propellent
  4. Ensure your tongue is placed under the mouthpiece so that it does not obstruct the opening
  5. Remember to breathe through the mouth and not the nose
  6. Take a deep, slow breath as you press down on the medication canister
  7. Hold your breath for approximately 10 seconds after inhalation (or as long as is comfortably possible)

How to use your dry powdered inhaler

  1. Remove the cap from the mouthpiece
  2. If using a single-use device, load a capsule into the device as instructed
  3. Exhale slowly and completely (away from the mouthpiece)
  4. Position the mouthpiece between the front teeth and seal your lips around it
  5. Breath in quickly and deeply through the mouth for 2-3 seconds
  6. Remove the inhaler from your mouth and hold your breath for 10 seconds (or as long as comfortably possible)
  7. Exhale slowly.

How to use a spacer device

  1. Assemble the spacer
  2. Remove the cap from your inhaler
  3. Ensure there is enough medicine in your inhaler to administer a dose
  4. Shake your inhaler holding it upright
  5. Insert your inhaler upright into the spacer device
  6. Place the mouthpiece between your teeth (without biting), closing your lips around it to form a good seal
  7. Exhale gently into the spacer
  8. Keeping the spacer horizontal, press down firmly on your inhaler canister once
  9. Single breath method - breathe in slowly and deeply
  10. Multi breath method - inhale and exhale normally for 3-4 breaths
  11. Hold your breath for 5-10 seconds or as long as you can comfortably manage
  12. Whilst holding your breath, remove the spacer from your mouth
  13. Exhale gently
  14. Disconnect your inhaler from the spacer device
  15. Replace the cap on your inhaler mouthpiece

Common asthma inhaler mistakes

When it comes to inhaler techniques there are some very common mistakes that people make. Some of these mistakes are specific to a certain device, and others apply to all types of inhalers. Below we highlight these mistakes and how you can rectify and optimise your inhaler technique:

Applies to all inhalers

Applies to MDI inhalers

Getting the best out of your inhaler

Below you will find some simple tips that will help ensure you are getting the most out of your inhalers. Adopting a good inhaler technique will allow you to receive the right dose of your medicine, which will better control your asthma symptoms.

Cleaning your inhaler

  1. Remove the canister and mouthpiece cap. Do not immerse or wash the canister in water
  2. Run warm water through the top and bottom of the actuator for approximately 30 seconds
  3. Check that any medicine build-up has been washed away from the mouthpiece. If there is still a build-up present, repeat step 2
  4. Shake off the excess water and allow to air-dry overnight
  5. Once dry, replace the canister into the actuator and spray once (away from face) to test
  6. Your inhaler should be cleaned at least once a week.

Cleaning your dry powdered inhaler

  1. Most dry powdered inhalers should not be cleaned with soap and water
  2. Clean the mouthpiece using a dry cloth
  3. Consult the information leaflet for further instructions.

Cleaning your spacer device

  1. Wash the spacer using a diluted solution of water and dishwasher detergent. Using just water will cause a electrostatic charge to develop, which will reduce the effectiveness of the spacer
  2. Allow to air-dry before next use. The spacer should not be dried using a towel or cloth
  3. Your spacer device should be cleaned once every 1-2 weeks.

Correct inhaler usage is an important skill for any asthmatic to acquire. Make sure you use yours correctly and keep it clean to get the most out of your asthma treatment. Incorrect inhaler practices can be detrimental to your health, so brush up on yours today!

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Scott McDougall

Authored by

Scott McDougall
Scott McDougall
MPharm
2079324
Director & Registered Manager

Scott is one of the two founders of The Independent Pharmacy. He is a registered pharmacist and the registered manager of our service with the CQC.

Daniel Hurley

Reviewed by

Daniel Hurley
Daniel Hurley
MPharm IP
2078790
Pharmacist Independent Prescriber

Dan is an experienced pharmacist having spent time working in both primary and secondary care. He currently supports our clinical team by providing robust clinical governance review of our internal processes and information.