Instructions for Using Two Different Inhalers

Your doctor might prescribe more than one inhaler for you to use in treating your asthma symptoms. You may be told to use a rescue inhaler, also called a reliever or puffer, "as needed" up to four times a day to quickly open the airways when you experience coughing, wheezing and difficulty breathing. You may also be prescribed a dry powder inhaler to be used once or twice each day, which is designed to control inflammation of the airways.

Never blow into your inhaler. Always use your inhaler exactly as prescribed by your doctor.

Rescue Inhalers

• The rescue inhaler delivers a metered, or measured, dose of medication to your lungs. These inhalers usually contain a short-acting bronchodilator, most commonly albuterol. This medication acts to quickly open your airways during an asthma attack.

  When you get your first inhaler, your doctor or a respiratory therapist will show you how to use it. When you open a fresh package, you will see the canister fits into a plastic holder. Open the door to the mouthpiece and prime the inhaler by pressing the canister several times until you see the mist come out of the mouthpiece.

  Always shake the inhaler before using it. Put the mouthpiece in your mouth and close your lips around it. Press the canister to deliver one spray to the back of your throat, while at the very same time breathing deeply into your lungs. Hold your breath for 10 seconds and release it. Inhale a second dose of medication in the same manner. Some rescue inhalers have a dose counter so you can see how many doses you have left.

Dry Powder Inhalers

• Dry powder inhalers deliver a long-acting medication to your lungs and are usually taken once or twice each day. They contain medications that decrease inflammation of the airways; some contain a second medication that helps to keep the airways open. Because these long-acting inhalers work over time, they are never to be used as a rescue inhaler.

  Unlike rescue inhalers, which require you to press the canister and inhale at the very same time, dry powder inhalers are prepared before they are used. Some require you to break a capsule (Spiriva) and some require you to push a lever (Advair) to prepare the inhaler for use.

  To use the Spriva Handihaler, open the dust cap by pressing the green button that pierces the medication capsule. Pull the dust cap up and open the mouthpiece by pulling out the mouthpiece. Take one tiotropium bromide capsule out of its blister pack and put the capsule into the middle chamber of your Handihaler. Close the mouthpiece until you hear a "click" and leave the dust cap open. Make sure the mouthpiece is sitting tightly on the base. Press the green piercing button--this breaks the medication capsule. Put your mouth on the mouthpiece, release all your breath and breathe in deeply and slowly, but at a speed that will make the medication capsule vibrate. Fill your lungs and hold your breath as long as you can. Then breathe normally.

  To use your Advair inhaler, hold the diskus in one hand and push the thumbgrip as far away from you as possible. The mouthpiece will come into view and snap open. Hold your diskus level and slide the inside lever away from you until it clicks. This releases the dry powder medication for use. Exhale completely, put the device in your mouth and breathe in quickly and deeply. Hold your breath for as long as you can, then release your breath slowly. Immediately rinse your mouth with water and spit the water out--do not swallow it. To close your diskus, move the thumbgrip back toward you until it stops. The device is now ready for its next use. The Advair diskus also has a convenient dose counter, so you'll know how many doses are left.