Asthma inhalers: do you follow instructions to the letter?

People with asthma need to take medication regularly to control their disease optimally and thus live with no (or very few) symptoms.

For the drug to travel to its site of action (the lungs) as directly as possible, most products against asthma are available as inhalers. However, studies have shown that a large number of people with asthma do not use their inhalers properly.

There are many types of inhalers, each with its own design features. Some contain a gas that propels the drug from the device when activated. With others, the drug is released when the person puts the device in his mouth and inhales, thus "pulling" the drug from the device into their lungs.

Even if the devices were designed to be easy to use, several studies have shown that the majority of asthmatics make at least one error when taking their medication. Here are some key points that need special attention when using an inhaler:

• After having primed the device to release a dose (the technique varies from model to model) and just before inhaling the drug, the person must expire to clear his or her lungs. With inhalers that contain a dry powder, it is important not to breathe out into or near the device, because the force of the air blown may be sufficient to push some of the drug out of the device. 
• When placing the device in the mouth, the lips must be tightly closed around the mouthpiece to avoid leaks.
• After inhaling the drug, the person must hold his or her breath for 5 to 10 seconds so the drug has time to be deposited in the lungs before exhaling.
• Finally, if the product contains a corticosteroid, it is essential to rinse the mouth with water after each dose to reduce the risk of developing a yeast infection.

Sometimes, as a result of the stress of having a new medication, someone may misunderstand some of the instructions on how to use a device. By constantly repeating the same mechanical gestures, bad habits may also develop overtime. For these reasons, people who use inhalers should take the time to review periodically how they use their devices with their pharmacist (or asthma educator) to make sure their technique is perfect!

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