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Metered dose inhalers (MDIs): How to use one when you have COPD

People who have chronic obstructive pulmonary disease (COPD) or certain other lung conditions often take their medications using devices called a metered dose inhaler (MDI) or dry powder inhaler (DPI). If you have COPD, your doctor will prescribe the medication you need to use in an MDI or DPI.

What is a metered dose inhaler?

A metered dose inhaler is a handheld device that delivers a specific amount of medication in aerosol form, rather than as a pill or capsule. The MDI consists of a pressurised canister inside a plastic case, with a mouthpiece attached. With an MDI, you press on the device while inhaling the COPD medication directly into your lungs. Another type of MDI is “ breath-actuated”. This means that it triggers automatically to deliver a dose when you breathe in, without you having to co-ordinate the pressing of the canister. You then have to re-set the inhaler so it will work the next time. The portability of MDI’s make them easy to use anywhere at anytime. MDIs use a chemical propellant to push medication out of the inhaler. The common propellant is heptafluoropropane (HFA). The harmful CFCs that were damaging to the ozone layer have now been phased out.

What is a dry powder inhaler?

Some medications can be taken in the form of a dry powder, using a dry powder inhaler, which is also a handheld device. A DPI delivers medication to the lungs as you inhale through it. It doesn't contain propellants or other ingredients - just your medication.

Why is it important to learn how to use my inhaler?

If you use the inhalers in the right way, you will receive the correct amount of COPD medication and it can reach deep inside your lungs. You can then gain the full benefit of the medication. You are also less likely to experience side-effects.

How do I use a metered dose inhaler?

Don’t worry if you find the instructions confusing or are not sure if you understand how to use your MDI properly. The steps described below will help you, but all GP practices will have someone (usually a practice nurse) who will take time with you to teach you how to use your inhaler and check that you are using it properly. Don’t be afraid to ask if you are having problems - failure to improve with an MDI is often due to poor inhaler technique.

These are the general steps for using a metered dose inhaler for COPD

  1. Remove the cap.
  2. Shake the inhaler for a few seconds.
  3. Place your index finger on top of the canister and thumb on the bottom of the mouthpiece.
  4. Tilt your head back slightly and breathe out.
  5. Hold the inhaler upright about the width of two fingers from your mouth.
  6. Breathe in and out slowly through your mouth once.
  7. Place the mouth-piece in your mouth and seal your lips around it
  8. Press down on the inhaler as you breathe in as slowly and deeply as you can - about 3 to 5 seconds.
  9. If possible, hold your breath for at least 10 seconds.
  10. If your doctor prescribed more than one puff of COPD medication, wait about one minute and repeat steps 2-8.
  11. Replace the cap.
  12. Gargle and rinse your mouth with water or mouthwash (usually advised only for steroid-type inhalers).


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