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Metered-Dose Inhaler, How to Use with a Spacer: Teen Version

A metered-dose inhaler is a pressurized container that releases a mist of medicine. You inhale the medicine into the airways of your lungs.

Inhaled asthma medicines contain a gas that helps the medicine get into your lungs. Chlorofluorocarbon (CFC) is the gas that used to be used in inhalers. Because it depletes the ozone layer in our atmosphere, hydrofluoroalkane (HFA) is now used instead. Although the gas in inhalers has changed, the medicine in HFA inhalers is the same as the medicine in CFC inhalers. The HFA inhaler looks just like a CFC inhaler but is a little different. The spray comes out with less force, is warmer, and has a slightly different taste. It is not felt as much in the throat when inhaled, but you still get the right amount of medicine.

A device called a spacer can be used with an inhaler to help you breathe in more of the medicine into your lungs with each spray. You attach one end of the spacer to the inhaler and put the other end into your mouth.

To attach the inhaler to the spacer:

  1. Remove the caps from the spacer and metered-dose inhaler.
  2. Shake the inhaler vigorously.
  3. If the inhaler has not been used before or if the inhaler has not been used for a while, you must then “prime” the inhaler. Do this by spraying 2 or 3 sprays of the medicine into the air. Each time you use the inhaler, the next dose is drawn into a chamber inside the inhaler. If the inhaler has not been used or sits for a long time without being used, some of the medicine leaks out of the holding area. This means you will not get the full dose of medicine the next time it is used. Priming the inhaler makes sure that you get the full dose of the medicine.
  4. Insert the mouthpiece of the inhaler into the rubber-sealed end of the spacer.

To use the inhaler with the spacer:

  1. Breathe all of the air out of your lungs.
  2. Put the spacer into your mouth between your teeth. Make a tight seal around the mouthpiece with your lips.
  3. Press the inhaler down once to release a spray of medicine. The medicine will be trapped in the spacer.
  4. Just after the mist fills the spacer, breathe in through your mouth slowly for about 5 seconds.
  5. Hold your breath for 10 seconds. This gives the medicine time to reach your airways.
  6. Take the spacer out of your mouth. Breathe out slowly.
  7. Take a few normal breaths and then repeat these steps for another inhalation (puff) if required. Take the number of puffs prescribed by your healthcare provider.
  8. If you are taking an inhaled steroid medicine, rinse your mouth and spit out the water after the last dose.

Cleaning the inhaler and spacer

Wash the spacer and the plastic case for the inhaler once a week with soapy tap water. Rinse well and let the parts air dry.

Replace the one-way valve or get a new spacer when the valve dries out and starts to curl.

Written by the Asthma Task Force at The Children's Hospital, Denver.
Published by RelayHealth.
Last modified: 2011-02-11
Last reviewed: 2010-12-13
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2011 RelayHealth and/or its affiliates. All rights reserved.
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