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Allergies and Asthma > How to use an HFA inhaler

How to use an HFA inhaler

inhaler-kid.jpgSteps to using an HFA Inhaler

  1. Remove the mouthpiece cap and look at the tiny exit hole where the medication comes out of the canister. It should be free of debris or white powder. If it’s not, follow package instructions to thoroughly clean the inhaler.
  2. Shake the inhaler to mix the crystalline powder medication with propellants and other inactive ingredients. Check your patient instruction sheet to see if your inhaler requires shaking (and how much), as a few brands (including Atrovent® HFA and QVAR®) are blended differently and don’t need shaking.
  3. Prime (actuate) the inhaler to release one dose of medication into the air. When the HFA is new or hasn’t been used in a while, the ingredients may separate. Discarding the first few doses (priming) ensures the next one you inhale contains the labeled amount of medication. Check your patient instruction sheet for details on your inhaler.
  4. Stand or sit up straight and exhale fully. This step ensures you can inhale medication slowly and deeply.
  5. Insert the inhaler into the chamber and put the mouthpiece between your teeth or the mask on the face. If you use a mouthpiece, insert the inhaler mouthpiece into the flexible adaptor and put the chamber mouthpiece in your mouth. Hold the inhaler upright, with the mouthpiece at the bottom and the top pointing up to the sky. Be sure to close your lips tightly around the mouthpiece and keep your tongue out of the way. If using a mask, it is important to keep a seal of the mask on the face at all times or the medication will not be inhaled. You can have your child sit on your lap facing outwards, and put your thumbs under the jaw and your fingers around the mask after pumping the inhaler.
  6. Continue inhaling slowly for 3-5 seconds, until your lungs are full. You might be surprised at how long a time that is, so test yourself. Using a stopwatch device or clock with a second hand, begin to inhale and pretend to actuate your inhaler. See how long it takes you to fill your lungs. Did you run out of room in your lungs before 3 seconds? If so, try it again, more slowly. Practice until you’re able to get it right. Then practice again … and again. Some holding chambers feature a whistle that goes off if you are inhaling too forcefully, a signal that you need to slow down.
  7. Hold your breath for 10 seconds, if possible. When you hold your breath, you allow the tiny particles of medication to settle on the surface of your airways, rather than being pushed back out.
  8. Exhale slowly and repeat steps 2 through 9 for second dose. If your asthma action plan says to take a second dose, check the patient instruction sheet that came with your inhaler to see how long to wait in between. Often this is about a minute, but some devices recommend a different amount of time.
  9. Replace the cap on your inhaler and store it where it won’t be exposed to moisture or extreme temperature changes. For best results, store and use the inhaler at normal room temperature — about 77°F. If you need to take your inhaler out in very cold or very hot weather, keep it close to your body, not in your car or in a backpack. In cold temperatures, warm the inhaler with your hands before using it. Check your medication instruction sheet to see if the inhaler must be stored upright.
  10. Mark your inhaler after each use (apply a blank mailing label prior to first use and make a tick mark with each use in groups of 5 to easily count) if there is not a dose counter. It is very important to replace the canister before it runs out!
  11. Rinse your mouth if you used an inhaled corticosteroid (Flovent, QVAR, Pulmicort, and many more prevention medications).

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