How to use a Standard MDI (puffer)

Using your inhaler (puffer) properly is important when you have asthma or COPD (chronic obstructive pulmonary disease).

This short clip shows you how to use a standard metered dose inhaler (MDI), often called a puffer.

Medications

A standard puffer is used with many different medications. These include:

• Airomir (salbutamol)
• Alvesco (ciclesonide)
• APO-Salbutamol (salbutamol)
• Asmol (salbutamol)
• Atrovent (ipratropium)
• Flixotide and Flixotide Junior (fluticasone propionate)
• Flutiform (fluticasone propionate)
• Intal and Intal Forte (sodium cromoglycate)
• Qvar (beclomethasone)
• Seretide (fluticasone propionate plus salmeterol)
• Tilade (nedocromil sodium)
• Ventolin (salbutamol)

Checklist of steps

1. Remove cap (some must be squeezed at the sides to release)
2. Check dose counter (if device has one)
3. Hold inhaler upright and shake well
4. Breathe out gently (away from inhaler)
5. Put mouthpiece between teeth (without biting) and close lips to form good seal
6. Start to breathe in slowly through mouth and at the same time press down firmly on canister
7. Continue to breathe in slowly and deeply
8. Hold breath for about 5 seconds or as long as comfortable
9. While holding breath, remove inhaler from mouth
10. Breathe out gently (away from inhaler)
11. If more than one dose is needed, repeat all steps starting from step 3
12. Replace cap

Common problems

• Holding the inhaler in the wrong position
• Not breathing in at the same time as pressing the canister
• Not breathing in deeply enough
• Not holding breath for long enough
• Taking several puffs without waiting or shaking the inhaler in between

Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.

Tips

• Keep your chin up and the inhaler upright (not aimed at the roof of your mouth or your tongue)
• If you are using a standard inhaler for a corticosteroid preventer medication, also use a spacer
• If you are using this inhaler for a corticosteroid preventer medication, with or without a spacer, rinse your mouth with water and spit after inhaling the last dose to reduce the risk of side-effects
• People with weak hands or osteoarthritis who have difficulty using a standard inhaler should ask their pharmacist about a Haleraid device

Getting the most out of your inhaler

Ask your doctor, pharmacist or asthma & respiratory educator to:

• Explain how your inhaler should be used
• Check you are using your inhaler properly
• Tell you where to find the expiry date on your inhaler
• Show you how to check if your inhaler is empty or nearly empty
• Discuss any unwanted effects from your medication
• Explain how to clean your inhaler and spacer (if you have one)

Different brands of inhalers sometimes have slightly different instructions to each other for similar steps. The checklists in our How-To Video library have been simplified and standardised where possible to reduce confusion.

Your inhaler will come with instructions in the package. Always check the package insert for any specific instructions.

Other inhaler types

See our complete How-to video library for other inhaler types and how to use them.

Acknowledgement

Thanks to Ms Judi Wicking, asthma and respiratory educator, and the patient who participated in this film clip.

Development of this How-to video was supported by the Australian Government Department of Veterans' Affairs as part of the Prevent Puffer Problems campaign. The National Asthma Council Australia retained editorial control.

Disclaimer

Although all care has been taken, this video is a general guide only, which is not a substitute for assessment of appropriate courses of treatment on a case-by-case basis. The National Asthma Council Australia expressly disclaims all responsibility (including for negligence) for any loss, damage or personal injury resulting from reliance on the information contained herein.