What should I know about using an asthma inhaler?

It is important to remember that the effectiveness of any medication is in part determined by proper use. When a metered-dose inhaler is used for asthma, the medication is released at a very high speed (60-80 miles per hour). This makes it difficult to coordinate the release of the puff at the same time as the inhalation of breath.

Further, placing the inhaler in the mouth can produce greater side effects from the drug being absorbed through the mouth into the bloodstream. This is the case with the MDI pirbuterol (Maxair Autohaler), which is activated automatically by placing the device in the mouth and taking in a deep breath. Thus, drug delivery to the airways is important.

A device called a holding chamber greatly enhances proper use of most inhalers. As most rescue inhalers require two puffs, it is essential to wait a minimum of two minutes before the second puff. This allows time for the first puff to open up the airways so that the second puff gets down even further into the smaller airways.

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