Recent Wall Street Journal Article Reported Common Inhaler Mistakes
People get less medicine by using their metered-dose inhalers improperly.
Not shaking it. Guidelines recommend shaking it before each puff. Doctors say often patients shake before the first puff but not subsequent ones. Shaking is what mixes the propellant and medicine.
Orientation. Inhalers should be held upright. Some patients hold them at angles or lean in too far which can cause the medicine to stick to the tongue or mouth instead of going down the airway to the lungs.
Coordination with breath. Patients are instructed to start inhaling slowly before activating the inhaler. Some patients wait too long before activating it or activate it before breathing.
Breathing in too quickly. Some patients take short breaths and stop, rather than breathing in slowly and deeply.
Holding the breath. Patients are supposed to hold their breath for five to 10 seconds before exhaling to let the medication settle in the lungs. Many exhale too quickly.
Spacing. Not everyone waits the recommended 15 to 30 seconds before taking the next puff.
The process of using the medicine-delivery devices requires multiple steps and studies have found that patients make at least one mistake as much as 70% to 90% of the time. The result: only about 7% to 40% of drugs is delivered to the lungs.