Correct Use of Inhalers

Full update February 2021

The various inhalation devices are likely to be equally effective in delivering medication when used correctly.1,2 However, up to 70% to 80% of patients may be using them incorrectly.6 Education and repetitive demonstration are key to proper inhaler technique.3 Choose a device based on the patient’s ability to use it properly (e.g., cognition, dexterity, strength), patient preference, and cost.1,2 Metered-dose inhalers (MDIs) usually require good hand-breath coordination (although the use of a spacer may help with this).1 Breath-activated inhalers (all of the dry-powder inhalers [DPIs]) require less hand-breath coordination, but require adequate strength of inhalation (e.g., difficult for very young children).3 Clinical information can be found in our charts, Inhaled Medications for COPD and Comparison of Inhaled Asthma Meds. The chart below includes steps for use, links to instructional videos, information on how to obtain demo inhalers, and how to prime and clean the devices.

Metered-Dose Inhaler (MDI)

There are two techniques for using MDIs (open-mouth and closed-mouth). All MDI manufacturers recommend a closed-mouth technique.3,7

General steps for use (closed-mouth technique):3,4

  • Stand or sit up straight.
  • Take the cap off the inhaler mouthpiece. Check for dirt or foreign objects. If using a spacer, take the cap off the spacer.
  • Shake the inhaler well, if necessary (noted for each individual brand of inhaler in rows below).
  • If using a spacer, connect the spacer and the inhaler together.
  • Breathe out through the mouth, away from the inhaler.
  • Put the mouthpiece in the mouth and tighten your lips around it. If using a spacer, put the spacer mouthpiece between your teeth and tighten your lips around it (if using a spacer with a mask, put the mask over the nose and mouth; ensure a tight seal against the face).
  • Press the canister down while inhaling slowly and deeply through your mouth (or, if using a spacer with a mask, take six normal breaths). If using a spacer, be aware that some spacers whistle if you are inhaling too quickly. Slow down your breath if you hear the whistle.
  • Move the mouthpiece away from your mouth.
  • Hold your breath for as long as you can comfortably (generally 5 to 10 seconds), then breathe out. If using a spacer, and you cannot hold your breath, take six normal breaths.
  • If you are supposed to take more than one puff, wait one minute before repeating, starting with “Shake the inhaler well…”

Instructional video (MDI without spacer): http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/mdi-no-spacer

Instructional video (MDI with spacer): http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/mdi-spacer-adult

Brands (MDI)

Additional Infoa,b

To request a demo inhaler

Advair
(fluticasone/salmeterol)

Shake before use? Yes
Priming: Before first use, spray until counter reads 120. If not used for a week or more: 2 sprays. Shake between sprays.
Cleaning: At least once a week. Remove mouthpiece cap and wipe mouthpiece inside and out with a dry cloth, tissue, or cotton swab. Replace cap.
Dose counter: Yes
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact GlaxoSmithKline at 800-387-7374

Airomir
(salbutamol)

Shake before use? Yes
Priming: Before first use, and if not used for two weeks or more: 4 sprays.
Cleaning: At least once a week. Remove canister and mouthpiece cap. Rinse inside mouthpiece with warm running water for at least 30 seconds, until no visible medicine build-up remains. Shake, air-dry thoroughly (e.g., overnight), and replace canister. If use is necessary before mouthpiece is dry: shake off water, replace canister, and test spray twice before use. After dose, re-wash and air dry.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Not available

Alvesco
(ciclesonide)

Shake before use? No
Priming: Before first use, and if not used for seven days or more: 3 sprays.
Cleaning: Once a week. Clean mouthpiece inside and out with a dry tissue. Also wipe over the small hole where the medicine comes out with a dry, folded tissue.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact Covis Pharma at 833-523-3009

Atrovent HFA
(ipratropium)

Shake before use? No
Priming: Before first use: 2 sprays. If not used for more than three days: 1 spray.
Cleaning: At least once a week. Remove canister and mouthpiece cap. Rinse mouthpiece with warm water to remove built-up medication and dirt. Shake, air-dry, and replace canister and cap.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Not available

Flovent HFA
(fluticasone)

Shake before use? Yes
Priming: Before first use, and if not used for seven days or more: 2 sprays. Shake before and between sprays.
Cleaning: At least once a week. Remove mouthpiece cap and wipe mouthpiece inside and out with a dry cloth, tissue, or cotton swab. After cleaning, spray once to make sure it works. Replace cap.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact GlaxoSmithKline at 800-387-7374

QVAR
(beclomethasone)

Shake before use? No
Priming: Before first use or if not used for more than two weeks: 4 sprays.
Cleaning: Weekly. Clean mouthpiece with a clean dry tissue or cloth.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Not available

Ventolin HFA
(salbutamol)

Shake before use? Yes
Priming: Before first use, and if not used for more than five days: 4 sprays.
Cleaning: At least once a week. Remove canister and mouthpiece cap. Rinse the outside and inside the mouthpiece with warm running water. Dry thoroughly. Replace canister and spray once to ensure inhaler works.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact GlaxoSmithKline at 800-387-7374

Zenhale
(formoterol/mometasone)

Shake before use? Yes
Priming: Before first use, or if not used for more than five days: 4 sprays. Shake between sprays.
Cleaning: Weekly. Wipe inside and outside of mouthpiece with a clean, dry, lint-free tissue or cloth.
Dose counter: Yes
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact your Zenhale sales representative at Merck Canada
800-567-2594, extension 3

Soft-Mist Inhaler (SMI): Respimat

General steps for use: (Respimat requires assembly before first use. See product labelling for instructions.)

  • With the cap closed, turn the base in the direction of the arrows on the label until it clicks (half a turn).
  • Open the cap until it snaps fully open.
  • Breathe out fully, away from the inhaler.
  • Put the mouthpiece in the mouth and tighten the lips around it. Do not cover the air vents.
  • While inhaling slowly and deeply, press the dose-release button and continue to inhale.
  • Hold your breath for ten seconds, or as long as is comfortable.
  • If another inhalation is needed, repeat the steps from “Turn the base…”
  • Once the complete dose has been given, replace the cap over the mouthpiece.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/respimat

Brands (SMI; Respimat)

Additional Infoa,b

To request a demo inhaler

Combivent Respimat
(salbutamol/ipratropium)

Shake before use? No
Priming: Before first use, or if not used for more than 21 days: spray the inhaler toward the ground until the aerosol cloud is visible, then spray 3 more times. If not used for more than 7 days (3 days for Combivent), spray the inhaler toward the ground for one spray.
Cleaning: At least weekly. Wipe the mouthpiece inside and out with a damp cloth or tissue.
Dose counter: Yes (approximate dose indicator)
Beyond-use date: Three months after first use

Contact your sales representative at Boehringer Ingelheim
800-263-2425

Inspiolto Respimat
(tiotropium/olodaterol)

Spiriva Respimat
(tiotropium)

Striverdi Respimat
(olodaterol) (Health Canada-approved, but not marketed)

Dry-Powder Inhaler (DPI): Aerolizer

General steps for use:

  • Remove the inhaler cover. Hold the base of the inhaler and twist the mouthpiece in the direction of the arrow to open.
  • Remove 1 capsule from its foil blister. Place the capsule in the capsule chamber in the base of the inhaler. Twist the mouthpiece back to close.
  • Hold the inhaler upright. Press both buttons on the sides one time, at the same time, then release them to pierce the capsule.
  • Breathe out fully, away from the inhaler.
  • Tilt the head back slightly. Hold the inhaler with the buttons on the sides (don’t push the buttons) and place it between the lips.
  • Breathe in steadily, as deeply as possible, through your mouth. You will hear a whirring noise during the inhalation. Remove the inhaler from your mouth. Hold your breath for as long as comfortably possible.
  • Open the chamber to see if any powder remains in the capsule. If yes, close the chamber and repeat the steps starting from “Breathe out fully…”
  • Open the mouthpiece, remove the used capsule, and discard it. Close the mouthpiece and replace the cap.

Instructional video: http://www.youtube.com/watch?v=VvKi7OEKQYk

Brands (DPI; Aerolizer)

Additional Infoa,b

To request a demo inhaler

Foradil
(formoterol)

Shake before use? No
Priming: No
Cleaning: Wipe any powder residue from mouthpiece and capsule compartment with a dry cloth or small, soft, clean brush.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Not available

Dry-Powder Inhaler (DPI): Breezhaler

General steps for use:

  • Remove cap and tilt open the mouthpiece.
  • Pull back the foil blister to remove one capsule. Place the capsule into the capsule chamber. Click the inhaler closed.
  • Hold the inhaler upright. Press the buttons on the sides, both at one time. You should hear a noise as a hole is poked in the capsule. Release the side buttons.
  • Breathe out fully, away from the inhaler.
  • Place the mouthpiece in your mouth with the buttons on the sides (don’t push the buttons) and seal your lips around the mouthpiece.
  • Breathe in quickly and deeply through your mouth. You will hear a whirring noise during the inhalation.
  • Hold your breath for up to five seconds (or as long as comfortably possible), while removing the inhaler from your mouth.
  • Open the inhaler to see if any powder remains in the capsule. If yes, close the inhaler and repeat steps starting with “Breathe out fully…”
  • Open the mouthpiece, tip out the used capsule, and discard it. Close the mouthpiece and replace the cap.

Instructional video: https://www.lung.ca/lung-health/get-help/how-use-your-inhaler/how-use-breezhaler

Brands (DPI; Breezhaler)

Additional Infoa,b

To request a demo inhaler

Atectura Breezhaler
(indacaterol/mometasone)

Shake before use? No
Priming: No
Cleaning: As needed. Wipe the mouthpiece with a clean, dry, lint-free cloth.
Dose counter: No
Beyond-use date: Use the new inhaler provided with each prescription and discard the old device.

Contact Novartis at 800-363-8883

Enerzair Breezhaler
(indacaterol/glycopyrronium/mometasone)

Onbrez Breezhaler
(indacaterol)

Shake before use? No
Priming: No
Cleaning: No
Dose counter: No
Beyond-use date: Use the new inhaler provided with each prescription and discard the old device.

Brands (DPI; Breezhaler)

Additional Infoa,b

To request a demo inhaler

Seebri Breezhaler
(glycopyrronium)

Shake before use? No
Priming: No
Cleaning: If desired. Wipe inside and outside the mouthpiece with clean, dry, lint-free cloth.
Dose counter: No
Beyond-use date: Use the new inhaler provided with each prescription and discard the old device.

Contact Novartis at 800-363-8883

Ultibro Breezhaler
(indacaterol/glycopyrronium)

Dry-Powder Inhaler (DPI): Diskhaler

General steps for use:

  • Remove the inhaler cover.
  • Check that the mouthpiece is clean.
  • If a new medication disk is needed, hold the edges of the white tray and pull it out until it stops. You will see four raised ridges.
  • Press the ridges on the sides to remove the tray.
  • Put the new medication disk on the wheel, flat side up. Slide the tray all the way back in until it clicks.
  • Keep the inhaler flat. Lift the flap on top of the inhaler straight up, then click it back into place to poke a hole in the blister. Lower the flap.
  • Breathe out fully, away from the inhaler.
  • Place the mouthpiece in the mouth, between your teeth and lips, keeping the inhaler flat. Do not cover the vents on its sides.
  • Take one quick deep breath in through the mouth.
  • Remove the inhaler from your mouth. Hold your breath for three seconds or as long as is comfortable.
  • If another inhalation is needed, pull out the white tray to advance the disk to the next blister. Repeat the steps from “Lift the flap on top...”
  • Once the complete dose has been given, replace the cover over the mouthpiece.

Instructional video: https://www.youtube.com/watch?v=sQI0a0ToSPo

Brands (DPI; Diskhaler)

Additional Infoa,b

To request a demo inhaler

Relenza Diskhaler
(zanamivir)

Shake before use? No
Priming: No
Cleaning: After each use. Wipe the mouthpiece with a tissue.
Dose counter: No
Beyond-use date: Manufacturer’s expiration date on the packaging

Not available

Dry-Powder Inhaler (DPI): Diskus

General steps for use:

  • Hold the inhaler with one hand. With the thumb of the other hand, push the thumb grip away from you until you hear a click. This opens the inhaler.
  • Slide the lever away from you until you hear another click (this loads the medication).
  • Breathe out fully, away from the inhaler.
  • Put the mouthpiece in the mouth and tighten the lips around it. Inhale steadily and deeply through the mouthpiece.
  • Remove the mouthpiece from the mouth. Hold your breath for about ten seconds, or as long as comfortably possible. Breathe out slowly.
  • Use the thumb grip to close the inhaler.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/diskus

Brands (DPI; Diskus)

Additional Infoa,b

To request a demo inhaler

Advair Diskus
(fluticasone/salmeterol)

Shake before use? No
Priming: No
Cleaning: No
Dose counter: Yes
Beyond-use date: One month after opening the foil pouch

Not available

Flovent Diskus
(fluticasone)

Shake before use? No
Priming: No
Cleaning: No
Dose counter: Yes
Beyond-use date: Manufacturer’s expiration date on the packaging

Serevent Diskus
(salmeterol)

Ventolin Diskus
(salbutamol)

Dry-Powder Inhaler (DPI): Ellipta

General steps for use:

  • Slide the inhaler cover down until you hear a click. This reveals the mouthpiece and vent, and loads the dose.
  • Breathe out fully, away from the inhaler.
  • Put the mouthpiece between the lips and close lips firmly around it.
  • Do not block the air vents with the fingers.
  • Breathe in steadily and deeply through the mouth.
  • Remove the inhaler from your mouth.
  • Hold your breath for as long as comfortably possible (at least 3 or 4 seconds).
  • Exhale slowly and gently.
  • Slide the inhaler cover up over the mouthpiece to close.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/ellipta

Brands (DPI; Ellipta)

Additional Infoa,b

To request a demo inhaler

Anoro Ellipta
(umeclidinium/vilanterol)

Shake before use? No
Priming: No
Cleaning: If desired. Clean mouthpiece with clean dry tissue after use.
Dose counter: Yes
Beyond-use date: Six weeks after opening the foil tray

Contact GlaxoSmithKline at 800-387-7374

Arnuity Ellipta
(fluticasone furoate)

Breo Ellipta
(fluticasone/vilanterol)

Incruse Ellipta
(umeclidinium)

Trelegy Ellipta
(fluticasone/umeclidinium/vilanterol)

Dry-Powder Inhaler (DPI): Genuair

General steps for use:

  • Remove the cap by pressing the arrows on the sides and pulling it off. Check that no foreign objects are in the mouthpiece.
  • Hold the inhaler level, with the mouthpiece facing the mouth, and the green button on the top. Do not tilt the inhaler.
  • Press the coloured button all the way down and release it. The coloured window should be green. (Press and release again if it is still red.)
  • Breathe out fully, away from the inhaler.
  • Place the mouthpiece in your mouth horizontally, with the coloured button facing up, and tighten your lips around it.
  • Breathe in strongly and deeply through your mouth. Do NOT hold down on the coloured button. You will hear a click if you are inhaling correctly. Keep breathing in even after hearing the click.
  • Remove the inhaler from your mouth. Hold your breath for as long as is comfortably possible. Breathe out slowly.
  • The coloured window should be red. If it is not, repeat the dose (starting at “Breathe in strongly and deeply” above), ensuring you take a strong, deep breath.
  • Replace the cap.

Instructional video: https://www.lung.ca/lung-health/get-help/how-use-your-inhaler/genuair

Brands (DPI; Genuair)

Additional Infoa,b

To request a demo inhaler

Duaklir Genuair
(aclidinium/formoterol)

Shake before use? No
Priming: No
Cleaning: If desired. Clean the outside of the mouthpiece with a dry tissue or paper towel.
Dose counter: Yes (approximate dose indicator)
Beyond-use date: 60 days after opening the sealed pouch

Contact AstraZeneca at 800-668-6000

Tudorza Genuair
(aclidinium)

Shake before use? No
Priming: No
Cleaning: If desired. Clean the outside of the mouthpiece with a dry tissue or paper towel.
Dose counter: Yes (approximate dose indicator)
Beyond-use date: 90 days after opening the sealed pouch

Dry-Powder Inhaler (DPI): HandiHaler

General steps for use:

  • Open the cap of the inhaler by pressing the green button, then pull the mouthpiece up.
  • Just before use, pull back the foil blister to remove one capsule. Put the capsule in the chamber. Close the mouthpiece. It should click.
  • Hold the inhaler upright, with the mouthpiece facing up. Press the green button on the side to poke a hole in the capsule.
  • Breathe out fully, away from the inhaler.
  • Keeping your head level, seal your lips around the mouthpiece. Do not block the air vents.
  • Breathe in slowly and deeply, but quickly enough to feel a vibration. This means you are inhaling correctly.
  • Remove the inhaler from your mouth. Hold your breath for as long as is comfortable (try counting to ten). Exhale normally.
  • Take another breath from the inhaler (using the same capsule) to ensure you receive all the medication.
  • Open the mouthpiece, tip out the used capsule and discard.
  • Close the mouthpiece and cap.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/handihaler

Brands (DPI; HandiHaler)

Additional Infoa,b

To request a demo inhaler

Spiriva
(tiotropium)

Shake before use? No
Priming: No
Cleaning: Once a month. Open cap and mouthpiece. Open base (lift piercing button). Rinse the whole device with warm water. Tip excess water onto paper towel and leave device to air-dry for 24 hours with the cap, mouthpiece, and base open. As needed, clean the outside of mouthpiece with a moist tissue.
Beyond-use date: After opening a strip, the capsules are good for five days. The HandiHaler device can be used for up to one year.

Not available

Dry-Powder Inhaler (DPI): Podhaler

General steps for use:

  • Hold the inhaler and unscrew the lid. Set the lid aside. Stand the inhaler upright on its base.
  • Hold onto the body of the inhaler and unscrew the mouthpiece. Set the mouthpiece aside.
  • Separate the morning and evening doses from the blister strip.
  • Roll back the foil that covers one capsule. Take the capsule out of the blister and place it in the capsule chamber of the inhaler.
  • Put the mouthpiece back on the inhaler and screw it on firmly.
  • Hold the inhaler with the mouthpiece pointing down. Press the button on the end of the inhaler all the way down one time, then release. This punctures the capsule.
  • Breathe out fully, away from the inhaler. Place the mouthpiece in your mouth and seal your lips around it.
  • Breathe in deeply through your mouth. Remove the inhaler from your mouth. Hold your breath for about five seconds. Exhale normally.
  • Take a few normal breaths, then repeat the steps starting with “Breathe out fully…” to take a second inhalation from the same capsule.
  • Open the mouthpiece, remove the used capsule from the inhaler, and discard it. (If the capsule still contains powder, put it back in the capsule chamber, punctured side first, then replace the mouthpiece and repeat the steps starting with “Breathe out fully...” If the capsule appears not to be punctured, put it back in the chamber, replace the mouthpiece, and repeat the steps starting with “Hold the chamber with the mouthpiece pointing down...” If the capsule is still not punctured, use the reserve inhaler.)
  • Repeat for the remaining three capsules of the dose. Replace the mouthpiece and wipe it with a clean dry cloth. Replace the lid.

Instructional video: https://www.tobipodhaler.ca/videos

Brands (DPI; Podhaler)

Additional Infoa,b

To request a demo inhaler

Tobi Podhaler
(tobramycin)

Shake before use? No
Priming: No
Cleaning: After each use. Wipe mouthpiece with a clean dry cloth.
Dose counter: No
Beyond-use date: Replace inhaler after seven days of use.

Contact your Tobi Podhaler sales representative at Mylan
877-540-7377

Dry-Powder Inhaler (DPI): Turbuhaler

General steps for use:

  • Unscrew the cover and remove it.
  • Hold the inhaler upright and turn the ridged base one way and back the other. You will hear a click (this loads the dose).
  • Breathe out fully, away from the mouthpiece.
  • Seal the mouthpiece between your lips and tilt your head back slightly.5
  • Breathe in strongly and deeply. Hold your breath for ten seconds or longer, if you can.5
  • Remove the inhaler from your mouth. Breathe out.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/turbuhaler%C2%AE

Brands (DPI; Turbuhaler)

Additional Infoa,b

To request a demo inhaler

Bricanyl Turbuhaler
(terbutaline)

Shake before use? No
Priming: Before first use. Remove the cover, hold the inhaler upright by the blue grip, turn in one direction as far as it will go, turn in the opposite direction as far as it will go. Repeat.
Cleaning: Once each week. Clean outside of the mouthpiece with a dry tissue.
Dose counter: Yes (approximate dose indicator)
Beyond-use date: Manufacturer’s expiration date on the packaging

Contact AstraZeneca at 800-668-6000

Oxeze Turbuhaler
(formoterol)

Pulmicort Turbuhaler
(budesonide)

Symbicort Turbuhaler
(formoterol/budesonide)

Dry-Powder Inhaler (DPI): Twisthaler

General steps for use:

  • Hold the inhaler upright by the base and remove the cap by twisting it in a counterclockwise direction (cap removal loads the dose).
  • Breathe out fully, away from the inhaler.
  • Place the mouthpiece in your mouth and tighten your lips around it, holding the inhaler flat. Do not cover the ventilation holes.
  • Breathe in quickly and deeply through the mouth.
  • Remove the inhaler from the mouth.
  • Hold your breath for about ten seconds, or as long as comfortably possible. Exhale.
  • Replace the cap, turning it in a clockwise direction and gently pressing it down, until a click is heard.

Instructional video: http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/twisthaler

Brands (DPI; Twisthaler)

Additional Infoa,b

To request a demo inhaler

Asmanex Twisthaler
(mometasone)

Shake before use? No
Priming: No
Cleaning: After each dose. Wipe the mouthpiece with a dry cloth or tissue.
Dose counter: Yes
Beyond-use date: Two months after opening the foil pouch

Contact your Asmanex Twisthaler sales representative at Merck Canada
800-567-2594, extension 3
  1. “Beyond-use date” means the date after which a medication should not be used. This may be sooner than the manufacturer’s expiration date if a medication is less stable after it is removed from protective packaging.
  2. Information is specific to the listed brand name product. Use/care information for generic inhalers may differ.

Canadian product information used for preparation of the above chart: Advair (June 2020), Airomir (December 2020), Alvesco (September 2020), Atrovent HFA (November 2019), Flovent HFA (October 2018), QVAR (December 2020), Ventolin HFA (November 2017), Zenhale (May 2020), Combivent Respimat (November 2019), Inspiolto Respimat (November 2019), Spiriva Respimat (May 2019), Striverdi Respimat (May 2019), Foradil (May 2013), Atectura Breezhaler (May 2020), Enerzair Breezhaler (July 2020), Onbrez Breezhaler (January 2015), Seebri Breezhaler (September 2016), Ultibro Breezhaler (January 2020), Relenza Diskhaler (July 2018), Advair Diskus (June 2020), Flovent Diskus (October 2018), Serevent Diskus (July 2014), Ventolin Diskus (November 2017), Anoro Ellipta (August 2017), Arnuity Ellipta (October 2018), Breo Ellipta (January 2019), Incruse Ellipta (September 2020), Trelegy Ellipta (June 2020), Duaklir Genuair (June 2018), Tudorza Genuair (June 2018), Spiriva HandiHaler (November 2017), Tobi Podhaler (July 2019), Bricanyl Turbuhaler (January 2018), Oxeze Turbuhaler (April 2018), Pulmicort Turbuhaler (November 2017), Symbicort Turbuhaler (September 2019), Asmanex Twisthaler (November 2020).

References

  1. Barrons R, Pegram A, Borries A. Inhaler device selection: special considerations in elderly patients with chronic obstructive pulmonary disease. Am J Health Syst Pharm 2011;68:1221-32.
  2. Dolovich MB, Ahrens RC, Hess DR, et al. Device selection and outcomes of aerosol therapy: evidence-based guidelines: American College of Chest Physicians/American College of Asthma, Allergy, and Immunology. Chest 2005;127:335-71.
  3. Gardenhire DS, Burnett D, Strickland S, Myers TR. A guide to aerosol delivery devices for respiratory therapists, 4th edition. American Association for Respiratory Care. https://www.aarc.org/wp-content/uploads/2018/03/aersol-guides-for-rts.pdf. (Accessed January 26, 2021).
  4. Canadian Lung Association. How to use a puffer (metered-dose inhaler) if you don’t have a spacer. July 42, 2018. http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/mdi-no-spacer. (Accessed January 26, 2021).
  5. Canadian Lung Association. Turbuhaler. July 24, 2018. http://www.lung.ca/lung-health/get-help/how-use-your-inhaler/turbuhaler%C2%AE. (Accessed January 22, 2021).
  6. Global Initiative for Asthma. Global strategy for asthma management and prevention, 2020. https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020-report_20_06_04-1-wms.pdf. (Accessed January 26, 2021).
  7. Gregory KL, Wilken L, Hart MK. Pulmonary disease aerosol delivery devices a guide for physicians, nurses, pharmacists, and other health care professionals. 3rd edition. 2017. https://www.aarc.org/wp-content/uploads/2018/03/aersol-guides-for-hcp.pdf. (Accessed January 26, 2021).

Cite this document as follows: Clinical Resource, Correct Use of Inhalers. Pharmacist’s Letter/Pharmacy Technician’s Letter. February 2021. [370228]