Inhaled medications are effective – when they’re used correctly

Chronic lung diseases like asthma and COPD affect an estimated 50 million Americans. Temporary breathing problems caused by respiratory infections are also common, especially during winter months. Inhaled medications can be effective treatments for all of them. Some inhaled medications are used regularly to decrease inflammation and keep airways open, preventing severe breathing problems that may lead to hospitalization. Others effectively open airways quickly when shortness of breath becomes severe. But whether an inhaler is used regularly or occasionally, it'll only work if the medication is delivered completely into the lungs.

That may seem obvious, but it turns out that most people don't use their inhalers correctly. And believe it or not, it doesn't matter whether you're using an inhaler for the first time, or you've been using it for years. Inhalers can be complicated. And if you use more than one, the mechanisms to activate the aerosol may be completely different. But even if you learn how to use it correctly, it's easy to stop paying close attention to technique over time. And when that happens, you may gradually notice you're not getting the same relief from your inhaler.

Ideally, a new inhaler prescription would prompt your pharmacist to take you aside and show you exactly how to use it. Then, every year or two your pharmacist would check your technique to make sure no bad habits were starting to crop up. But we don't live in an ideal healthcare world. Community pharmacists are great healthcare professionals who simply aren't given enough time to provide a lot of healthcare.

Common administration mistakes with inhaled medications

So you may find yourself on your own trying to use your inhaler correctly. Here are some common examples of forgotten (or misunderstood) details that can cause inhaled medications to be ineffective:

• "Rescue" inhalers are sometimes used infrequently. They need may need to be "primed" before using if it's been a while. Or they may actually expire -- we all know time flies! Either of those issues can mean you won't get relief from your symptoms.

• Certain inhalers use an indicator to let you know that a dose is ready to inhale, or has been delivered effectively. Forgetting to watch the indicator can mean that you missed a step but don't know it. Learning whether your inhaler has an indicator, then keeping an eye on it, can make a big difference.

• New inhalers often need to be "primed" before the first use. Not all inhalers require this, but many do, and omitting this step can mean you won't get a complete dose of medication.

• If you use one medication regularly to keep your lungs healthy, and another to treat acute symptoms, be sure you know which is which. In the past few years we've learned that for some chronic lung diseases you can use the same inhaler for both. But if you're not sure, ask your doctor or pharmacist.

• Any inhaler that contains an anti-inflammatory (corticosteroid) requires rinsing the mouth after each dose. It's not just for fun -- that anti-inflammatory action makes it harder for your mouth to fight off painful thrush infections in the mouth or throat. 

• Many inhalers have a dose counter that tells you when there are no more doses left. It's easier than you might think to overlook the counter. And you might still feel an aerosol, so unless you look you may not realize there there isn't enough medication left to deliver a full dose.

Those are just a few examples of common mistakes that we all can make when using inhalers. And when we do, the medication may simply not do the job it was intended to do.

So  many different types of inhalers!

To complicate matters further, researchers continue to find new and better ways to deliver medications to the lungs. So if you have more than one inhaled medication, you may have more than one technique to learn. And even the same medication may suddenly change delivery methods.

Where can you get help with technique? 

If you use a pharmacy that allows pharmacists time for counseling, make an appointment! Your pharmacist can check your technique and give you pointers to improve it if necessary. And if you get a prescription for a new inhaler, ask your pharmacist to show you how to use it. At Better My Meds we're always ready to help you get the best health outcomes from your inhaler!

Another great way to learn is through instructional videos.  There's a video on the internet for nearly every type of inhaler. Search first by brand name ("Pulmicort Flexhaler" for example, rather than the generic "budesonide"). Watch it with a friend or family member then have them watch you. You'll find links to a wide variety of how-to videos on our online resources page. Because different medications are often delivered using the same type of inhaler, the videos are listed by inhaler type rather than by medication, so for example you'll find instructions for the Symbicort Turbohaler under "turbohaler", for Breo Ellipta under "ellipta", and so forth. If you don't find a video for your inhaler, send me a comment and I'll find one to add to the list!

Get the most from your inhaled medications with help from your pharmacist!

Inhalers are expensive on many insurance plans. At Better My Meds we want to help you get the full benefit of that medication. As always, we invite your comments and questions in the space below. Or contact us directly -- we love hearing from you!

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