A leading cause of inadequate asthma control is poor inhaler technique. If you are on a controller medicine for example, an inhaled steroid, and rarely miss doses, you should have rare symptoms of cough, wheezing or shortness of breath. If your technique is flawed you may be getting very little of the inhaled medicine into the lung where it needs to go. When I have my patients show me how they use their inhalers I often find important steps that are either overlooked or poorly done. Many times people forget to completely empty their lungs (blow all the way out) before inhaling the medicine. If you do not completely exhale, you cannot fully inhale the medicine deep into the lung airways. There are many types of inhalers (aerosols, dry powder, breath-actuated) but all of them require deep inhalation into the lung for optimal results.
Another common error associated with aerosol inhalers (for example Albuterol, Flovent or Qvar) is poor timing of pressing the canister to spray the medicine through the mouth piece, in relation to breathing in. Often people hesitate a second after spraying , and then breathe in allowing for the medication to bounce in and out of the mouth and coat the inner mouth surfaces. Less medication reaches the deeper lung channels in this case.
Most inhaled medications require a ten second breath hold after they are fully inhaled. Often times people hold the medication in their chest for 7 or less seconds (especially when in a rush or distracted).
Finally, forgetting to shake the inhaler (only aerosols, MDIs- metered dose inhalers) may be a crucial oversight. Many of the compressed air inhalers are mixtures of medication and propellant. If they are not shaken well before used, the medication leaving the mouthpiece may be less effective.
Just think of the waist of time and money when medications are not properly taken. You may have more medication added on, or have higher doses of drugs prescribed when initial treatment fails. It's a shame if the failure is due to poor inhaler technique.
Ask your doctor or nurse to check your inhaler technique every time you go in to the medical office.
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