inhaler devices.pptx

This is a highly informative summary about different inhaler devices regarding their use, storage, looking after them, common mistakes during use and when to start a new inhaler. Have a nice look.
Taking into your consideration that all images are hyperlinked with videos demonstrating the use of inhalers and cleaning which greatly helps you to master the techniques.

1. Inhaler Devices Dr: Wafaa Mohamed Korany

2. Misuse of Inhalers

3. ILOS Different types of inhaler devices How to use the inhaler How to asses proper use of the inhaler Common mistakes when using the inhaler How to look after the inhaler Storing the inhaler When to start a new inhaler In-Check DIAL G16 Inspiratory Flow Measurement (inspiratory flow <30 l/min) slow and steady inhalation (gentle) through the mouth Aerosol MDI and Respimat devices DPI ( multiple dose or capsule) (inspiratory flow 30-60L/min) Inhales forcibly and deep through the mouth

4. Metered Dose Inhalers (aerosol) Dry Powder Inhalers Soft Mist Inhalers Pressurized MDI Breath-actuated MDI Multiple Dose Inhalers Single Dose Inhalers (Capsule) Respimat Easybreathe Autohaler Accuhaler Ellipta NEXThaler Turbohaler flexhaler Twisthaler Clickhaler Novolizer Pressair Respiclick Forspiro Easyhaler Aerolizer Breezhaler Handihaler zonda Rotahaler Inhaler Devices

5. Aerosol Inhalers General Roles Straighten and slightly extend backward the neck Aerosol: Shake for 5 seconds Open and prepare Exhale away from device through the mouth Good lip seal Aerosol: slow and steady inhalation (gentle) through the mouth(inspiratory flow <30 l/min) and at the same time press down firmly on the canister Take the inhaler out while holding breath Hold the breath for 10 seconds Close the inhaler Rinse the mouth and do not swallow (if it contains steroids) 10 9 8 7 6 5 4 3 2 1

6. Aerosol (p MDI) Propellant Priming 4 puffs in the air away from your face New one Not used for 2 weeks Vental Ventolin Asmol Atimos Metrovent Atrovent Atrovent Comp Ipravent s Beclo Beclosone Beclosone forte Clenil forte Budecort Flixotide Alvesco Vental Comp Flutiform Seretide Trimbow

7. Remove the cap Hold the inhaler upright and shake well Breathe out gently away from the inhaler Put mouth piece between teeth without biting and close lips to form good seal Breathe in slowly through mouth and at the same time press down firmly on the canister Keep breathing in slowly and deeply Hold breath for about 10 seconds While holding breath remove inhaler from mouth Breathe out gently away from the inhaler If an extra dose is needed repeat steps 2-10 Replace the cap Checklist p MDI use

8. How to look after your MDI our inhaler can get blocked, especially where the medicine sprays out. Clean your inhaler weekly. To clean the inhaler, remove the plastic cap, remove the metal canister (don't put it in water), rinse the plastic case under warm water for at least 30 seconds. Shake off any excess water, and leave the plastic case and cap to dry overnight. Put the metal canister back in, and replace the cap.

9. Storing your inhaler Keep the cap on your inhaler.   Keep your inhaler at the correct temperature. Keep your inhaler somewhere dry. Carry a spare clean plastic case so you can change it if the one you are using becomes blocked.

10. By shaking the inhaler Always have a spare inhaler ready It may help to write the start date on the inhaler When to start a new inhaler

11. Common problems when using MDI Breathing in too fast. Breathing out so hard that you cough. Pressing the puffer too early before you have started to breathe in (if you see a mist of medication from your mouth, then you are making this mistake). Stop breathing in when feeling the aerosol. Tilting your head down – it should be tilting back slightly. Pressing the inhaler two times during a single inhalation. Giving the inhaler a 'test puff' into the air and wasting the medication. Breathing in through the nose instead of the mouth.

12. Inhaled medicine you get using different spacer devices P MDI spacer

13. Valved holding chambers Antistatic Aero chamber Spacer Non anti static (traditional)

14. Single breath method ( adult) Multiple breath method ( children) Multiple breath method < 4 years

15. Assemble spacer (If necessary) Remove inhaler cap Hold inhaler upright and shake well Insert inhaler upright into spacer Put mouthpiece between teeth without biting and close lips to form good seal Breathe out gently, into the spacer Hold spacer level and press down firmly on inhaler canister once Breathe in slowly and deeply . Hold breath for about 10 seconds While holding breath, remove spacer from mouth Breathe out gently Remove inhaler from spacer If an extra dose is needed, repeat steps 2 to 14 Replace cap and disassemble spacer Checklist p MDI & spacer (Single Breath)

16. Assemble spacer" (If necessary) Remove inhaler cap Hold inhaler upright and shake well Insert inhaler upright into spacer Put mouthpiece between teeth without biting and close lips to form good seal Breathe out gently, into the spacer Hold spacer level and press down firmly on inhaler canister once Breathe in and out normally for 3 or 4 breaths Remove spacer from mouth Breathe out gently Remove Inhaler from spacer If an extra dose is needed, repeat steps 2 to 14 Replace cap and disassemble spacer Checklist p MDI & spacer (Tidal Breathing )

17. When and how to prime the spacer New spacer After cleaning long time without use 6 Puffs

18. How to look after your spacer Wash your spacer once a week with warm water and dishwashing liquid. Don’t rinse. Drip dry. This reduces the electrostatic charge so that the medicine does not stick to the spacer sides 

19. When to replace the spacer Check for cracks if present . If used regularly your spacer may need to be replaced every 12-24 months.

20. Aerosol ( breath actuated MDI ) Easi - Breathe Shake Slow steady inhalation Breath activated for release of medication Priming (2 puffs) Do not block vents above 2 in 1 Easi-Breathe Qvar

21. Aerosol ( breath actuated ) Autohaler Shake Slow steady breath in Breath activated for release of medication Push lever up Airomir qvar

22. Dry Powder Inhalers General Roles Click (hear and do not repeat)(not for release of medication) Straighten and slightly extend backward the neck Open and prepare Breath activated ( breathing in release the medication) Do not shake (except easyhaler ) Exhale away from device through the mouth Good lip seal Inhales forcibly and deep through the mouth(inspiratory flow 30-60L/min) Take the inhaler out while holding breath Hold the breath for 10 seconds Close the inhaler Rinse the mouth and do not swallow (if it contains steroids) 10 9 8 7 6 5 4 3 2 1

23. Dry Powder ( Multiple Dose Inhalers) Accuhaler (Diskus) Horizontal Seretide Flixotide Serevent

24. Check dose counter Open cover using thumb grip Hold horizontally load dose by sliding lever until it clicks Breathe out gently, away from the inhaler Place mouthpiece in mouth and close lips to form a good seal, keep inhaler horizontal Breathe in steadily and deeply Hold breath for about 10 seconds While holding breath, remove inhaler from mouth Breathe out gently, away from the inhaler If an extra dose is prescribed repeat steps 3 to 9 Close cover to click shut Checklist for diskus use

25. Dry Powder ( Multiple Dose Inhalers) Ellipta Do not block vent 2-in-1 Trelegy incruse

26. Check dose counter Slide the cover down until you hear a click (do not shake) Breathe out gently, away from the inhaler Place mouthpiece in mouth and close lips to form a good seal Do not cover air vent Breathe in steadily and deeply Hold breath for 10 seconds While holding breath, remove inhaler from mouth Breathe out gently, away from the inhaler Sade the cover upwards as far as it will go, to cover the mouthpiece Checklist for Ellipta use

27. Dry Powder ( Multiple Dose Inhalers) NEXThaler Do not block vent 2-in-1 Fostair

28. Dry Powder ( Multiple Dose Inhalers) Turbohaler Twist Symbicort Oxis Bricanyl

29. Unscrew and remove cover Check dose counter Keep inhaler upright while twisting grip Twist around and then back until click is heard Breathe out gently, away from the inhaler Place mouthpiece between teeth without biting and close lips to form a good seal. Do not cover air vents Breathe in strongly and deeply Hold breath for about 10 seconds Remove inhaler from mouth Breathe out gently away from the inhaler If an extra dose is needed, repeat steps 2 to 10 Replace cover Checklist Turbohaler for use

30. Dry Powder ( Multiple Dose Inhalers) Flexhaler Pulmicort

31. Dry Powder ( Multiple Dose Inhalers) Twisthaler Arrow should line up with the dose counter Asmanex

32. Dry Powder ( Multiple Dose Inhalers) Clickhaler Click Asmasal Asmabec

33. Dry Powder ( Multiple Dose Inhalers) Novolizer Cartilage Salbulin Budelin

34. Dry Powder ( Multiple Dose Inhalers) Pressair ( Genuair ) Green - Red Eklira Duaklir

35. Dry Powder ( Multiple Dose Inhalers) Respiclick ( spiromax ) 2 in 1 Spiromax Duoresp

36. Dry Powder ( Multiple Dose Inhalers) each single dose contained in a separate blister in a foil strip Forspiro airflusal

37. Dry Powder ( Multiple Dose Inhalers) Easyhaler Shake Ventolin Formoterol

38. Dry Powder (S ingle Dose Inhalers) Aerolizer ( cyclohaler ) Metrohaler Foradil

39. Remove cap Hold base and twist mouthpiece to open (follow arrows) Remove capsule from blister and place in chamber Close mouthpiece Press side buttons in together once and release Breathe out gently, away from the inhaler Place mouthpiece in mouth and close lips to form a good seal, keep inhaler horizontal Breathe in quickly and deeply Hold breath for about 10 seconds . While holding breath, remove inhaler from mouth Breathe out gently Open mouthpiece to check if capsule is empty If powder remains repeat steps 6 to 11 Open mouthpiece and remove capsule If more than one dose is needed repeat steps 3-12 Close mouthpiece and cap Checklist for Breezhaler use

40. Dry Powder ( Single Dose Inhalers ) Neohaler ( breezhaler ) Seebri Onbrez Ultibro

41. Remove cap Flip mouthpiece to open Remove capsule from blister and place in chamber Close mouthpiece until It clicks Press side buttons in once and release (do not shake) Breathe out gently, away from inhaler Put mouthpiece between teeth without biting and close lips to form good seal Breathe in quickly and steadily, so capsule vibrates Hold breath for about 10 seconds While holding breath, remove inhaler from mouth Breathe out gently, away from Inhaler Open mouthpiece to check if capsule is empty If powder remains repeat steps 6 to 11 Open mouthpiece and remove capsule If more than one dose is needed repeat steps 3-12 Close mouthpiece and cap Checklist for Breezhaler use

42. Dry Powder ( Single Dose Inhalers) Handihaler Spiriva

43. Open cap Flip open mouthpiece Remove capsule from blister and place in chamber Close mouthpiece until It clicks Press green piercing button in once and release (do not shake) Breathe out gentry, away from inhaler Place mouthpiece between teeth without biting and close lips to form a good seal Breathe in slowly and deeply , so capsule vibrates Keep breathing in for 10 seconds While holding breath, remove inhaler from mouth Breathe out gently, away from inhaler Open mouthpiece to check if capsule is empty If powder remains repeat steps 6 to 11 Open mouthpiece and remove capsule. If more than one dose is needed repeat steps 3-12. Close mouthpiece and cap Checklist for Handihaler use

44. Dry Powder ( Single Dose Inhalers) zonda Braltus

45. Dry Powder ( Single Dose Inhalers) Rotahaler Detachment not piercing Ventolin rotacaps

46. Cleaning the inhaler device  wipe the mouthpiece with a clean dry tissue. Do not wash the mouthpiece or allow it to get wet when cleaning. 

47. Storing your inhaler Keep the cap on your inhaler.   Keep your inhaler at the correct temperature. Keep your inhaler somewhere dry. Store all medicines safely

48. When to start a new inhaler Dose Counter (Turns red or 00)

49. Common problems when using DPI Not loading a dose before using the inhaler. Tilting your head down – it should be tilting back slightly. Not breathing in strongly enough to draw the medication out of the inhaler and in to your lungs. Stop breathing in when feeling the powder. Breathing in through the nose instead of the mouth. Breathing out when taking the inhaler out of the mouth . Not holding your breath long enough after using the inhaler. Getting moisture inside the inhaler. Not closing the inhaler cover after use. Swallowing the capsule. Not piercing the capsule or multiple piercing.

50. S oft mist Respimat Insert the cartilage Priming (4) Prepare (by twisting half a circle) Open Press the button for release Inhale slow and steady Do not block vents Spiriva spiolto

51. Hold inhaler upright with the cap closed Turn base in direction of arrows until it clicks Open the cap until it snaps fully open Breathe out gently, away from inhaler Place mouthpiece in mouth and close lips to form a good seal. Do not cover air vents Breathe in slowly and deeply through mouth and, at the same time, press down on the dose button Keep breathing in slowly and deeply Hold breath for 10 seconds While holding breath, remove inhaler from mouth Breathe out gently, away from inhaler Click cap shut Two inhalations is the usual dose for medicines used with Respimat, Repeat from step 1 to get the full dose Checklist for Respimat use

52. Metered Dose Inhalers (aerosol) Multiple Dose DPI Single Dose DPI (Capsule) Respimat

53. Choose check Correct Confirm Strategies to ensure effective use of inhaler devices

54. Thank you