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Inhaler technique

anybody have any tips/tricks for using dry powder inhalers? I love the hfa and respimat inhalers, but never ever really felt comfortable with dpi’s. Does anyone have any secrets or videos on how to use them properly? When I took advair and arnuity it always seemed like more got on my tongue and mouth than down into the lungs. The first time I used it I didn’t get all the powder out and the white residue went everywhere in my purse … I was like great, this is gonna be the day I get pulled over or something, lol. I’m having a mediocre breathing day, and I think getting back on an ics/laba might be the next step … anything to get off the pred rollercoaster!

oh! Has anyone had any experience with advair vs symbicort and did either seem to  work better? Or did either produce more side effects?

thanks -em

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  • K8sMom2002

    National Jewish has these . And National Childrens has this video for using a dry powder inhaler — along with the tip, "Hold it like a hamburger, suck like a milkshake." 

    Could you ask your doctor or nurse to watch you use your inhaler technique and give you some tips? 

  • Emelina

    Sweet, thanks Cynthia. Good ideas, I’ll chat with my docs the next time I see them. The hfa’s and respimats are so easy, I think my lungs are getting lazy! My friend posted a recent article in The NY Times about a study out of Colorado that most kids don’t use their inhalers properly (hfa’s) because there are at least 8 different steps and most don’t wait the necessary amount of times between puffs! It’s shocking really. We get handed inhalers often without good teaching. Can you imagine if they handled diabetes the same way. Here’s some insulin, some wipes and syringes and needles, good luck! 

  • LK

    I've taken Advair several years ago but not Symbicort so I can't compare the two.  Advair gave me very dry mouth and it seemed to dry out my eyes as well.  My opthamalogist recommended Systane nighttime eye ointment at night and that helped.

    I currently take Breo Ellipta.  I try to make sure I exhale fully away from the device, breathe in deeply, hold my breath for ten seconds, exhale very slowly, rinse my mouth 2-3 times and gargle, wipe the mouthpiece with a kleenex, and close the cover.  

    I still get dry mouth from the meds but I use Biotene toothpaste for dry mouth and that helps.  There is also a spray, gel and oral rinse that help with dry mouth.  I have only used the spray some time ago.  

    A suggestion – If the DPI feels like it is getting more in your mouth than in your lungs, make sure you are holding the device so it is, as it says so well above, "like a hamburger"  .  I hold it horizontally as I inhale.  That seems to deliver most of the medicine into my lungs.

    Good luck!!  

  • LK

    Em,  Totally agree that we need more teaching about how to use our inhalers and other meds.  Maybe even every few months or once a year we also need a refresher course on all of it!  It is so easy to slip into bad habits without even realizing it. 

    Thanks Cynthia, for the great information!!  

  • K8sMom2002

     Lisa, thanks for the personal experience and insight … it's great for someone who uses a device like this daily to explain WHY we should hold it "like a hamburger."

    Em, you are SO right … but it's not just kids who sometimes don't know how to use their inhalers properly. Many adults think spacers are optional and only for little kids who are still learning how to use an inhaler. In fact, when my first doc prescribed me an inhaler, it was my wonderful pharmacist who taught me how to use an inhaler properly, and with a spacer. 

  • Emelina

    Lisa, thanks for the tips. I’ll try the hamburger method and make sure I keep it horizontal. It’s tough to learn when you only take it twice per day! Oh! I hadn’t thought to try biotene to help with the dry mouth. Nifty, thank you! 

    Cynthia, it’s incredible. Either docs love spacers or they hate them. I asked an old primary care doctor once for a spacer and she said, but you’re not a kid, you don’t need one! Now I swear by mine. Pharmacists are the best; it takes a special person to do that job! 

  • Pljohns

    Em-you are so right that doctors either love spacers or hate them-my old immunologist gave me one but pulmo hates them-go figure.  the only inhaler I have is my Qvar-I can't use any others and the only thing we can figure with the qvar is the steroid counter acts the issue caused by the HFA propellant.  I know with my neb, I've had to learn to keep the mouthpiece pretty much flat "like a hamburger" to get the most meds possible.

  • Emelina

    I love the hold it like a hamburger analogy! It’s a great reminder but now I chuckle Because on lower dose pred I wanna eat everything! 🍔 I had a mishap and dropped my neb. Atrovent took one for the team! 😭

  • Deborah Bartlett
    Emelina posted:

    Lisa, thanks for the tips. I’ll try the hamburger method and make sure I keep it horizontal. It’s tough to learn when you only take it twice per day! Oh! I hadn’t thought to try biotene to help with the dry mouth. Nifty, thank you! 

    Cynthia, it’s incredible. Either docs love spacers or they hate them. I asked an old primary care doctor once for a spacer and she said, but you’re not a kid, you don’t need one! Now I swear by mine. Pharmacists are the best; it takes a special person to do that job! 

    Em! Just don't put ketchup on your hamburger!!🍔😂

  • MizWheezie

    I've never had any problems with my Advair inhaler, it's those pesky little Albuterol inhalers that I've never been able to "master"  – The key (for me) is to make sure I'm holding the inhaler in an upright and horizontal position – Then, I fully exhale, place the mouthpiece securely and tightly between my lips, and then inhale, quickly and as deep as possible…

    I hold my breath for 10 seconds, then exhale slowly, and immediately gargle and rinse my mouth out with water (or mouthwash). 

  • LK

    MizWheezy,  Do you use a spacer with your albuterol inhaler?  My albuterol ProAir inhaler works SO much better for me with the spacer.

  • Emelina

    Lol Deborah! Ketchup and pickles! Thanks again all for the advair dpi tips! Definitely working, I don’t get the nasty film/taste on my tongue anymore! 

  • MizWheezie

    No, Hon, I've never used a spacer – But Albuterol doesn't help me any way – I'm still wheezing 15 minutes after a puff – Just using Advair now. 

  • Melissa G

    Mizwheezie, uughh on Albuterol not helping you! Have you tried using a nebulizer to administer the albuterol instead of an inhaler? 

  • Deborah Bartlett

    Sometimes I do not have enough breath to take puff of Albuterol…in an extreme situation. Doc told me to use Albuterol in the nebulizer.