Using Asthma Medications

Most people have an inhaler, or puffer, that they use to take asthma medicine. It is highly recommended that everyone, adults and children, attaches a spacer when using an inhaler. 

Spacers increase the amount of medicine that reaches the airways and can decrease side effects. When using a spacer correctly, more medicine will get into the lungs. Use a spacer as instructed by health care providers.

Other kinds of inhalers, called Diskus, Twisthaler and Flexhaler, are used to deliver long-term control medicines.

Another device used to take asthma medications is called a nebulizer. ANebulizer turns medicine into a mist that you can breathe deeply into your lungs. Often medicines can be mixed together in a nebulizer. Check with your doctor or a pharmacist about mixing medicines.

See the following directions for use:

• Using an Inhaler with a Spacer.
• Using an Inhaler with a Mask and Spacer.
• Using an Inhaler with No Spacer.
• Using a Diskus Inhaler.
• Using an Asmanex Twisthaler.
• Using a Flexhaler Inhaler.
• Using a Nebulizer.

Using an Inhaler with a Spacer

Click to download a printer-friendly version. (171 KB pdf)

Click to download a printer-friendly version in Spanish. (172 KB)

1. Stand or sit up straight.
2. Remove cap from the spacer and the inhaler. Look into the spacer/inhaler and remove/clean any dust.
3. Attach the inhaler to a spacer.
4. Shake the inhaler (10 shakes).
5. Hold the spacer close to your mouth and breathe out naturally.
6. Put the spacer mouthpiece between your teeth and close your lips.
7. Press down once on the inhaler.
8. Breathe in slowly and keep breathing in slowly until your lungs are full.
9. Remove the spacer from your mouth and close your lips. Hold your breath for 10 seconds.
10. Breathe out slowly.
11. Breathe in once more through the spacer without pressing on the inhaler.
12. Wait 60 seconds.
13. Repeat steps five through 12 for each puff that your health care provider tells you to take.
14. Rinse mouth.
15.  Remove the canister of medicine and rinse the plastic holder with water. Shake off excess water and let dry overnight.

Page Up

Using an Inhaler with a Mask and Spacer

Click to download a printer-friendly version. (142 KB pdf)

Click to download a printer-friendly version in Spanish. (144 KB)

1. Stand or sit up straight .
2. Remove cap from the spacer and the inhaler. Look into the spacer/inhaler and remove/clean any dust .
3. Attach the inhaler to the end of the spacer.
4. Attach the mask to the other end of the spacer.
5. Shake the inhaler (10 shakes).
6. Press the mask around the nose and the mouth, making a tight seal.
7. Press down on the inhaler.
8. Breathe in and out six to10 times (caregivers can watch the spacer valve move back and forth).
9. Remove the mask and spacer from your face. Wait 15 seconds.
10. Repeat steps five through nine for each puff that your health care provider tells you to take.
11. Clean face and rinse mouth.
12.  Wipe face with clean, wet cloth.
13. Remove the canister of medicine and rinse the plastic holder with water. Shake off excess water and let it dry overnight.

Page Up

Using an Inhaler with No Spacer

Click to download a printer-friendly version. (147 KB pdf)

Click to download a printer-friendly version in Spanish. (147 KB)

1. Stand or sit up straight.
2. Remove cap from the spacer and the inhaler. Look into the inhaler and remove/clean any dust .
3. Shake the inhaler (10 shakes).
4. Breathe out naturally.
5. Tilt head back slightly. Hold the inhaler two finger widths away from your mouth.
6. As you begin to inhale, press down on the inhaler.
7. Keep breathing in slowly until your lungs are full.
8. Remove the inhaler from your mouth and close your lips. Hold your breath for 10 seconds.
9. Breathe out slowly.
10. Wait 60 seconds.
11. Repeat steps four through 10 for each puff that your health provider tells you to take.
12. Rinse mouth.
13. Remove the canister of medicine and rinse the plastic holder with water. Shake off excess water and let it dry overnight.

Page Up

Using a Diskus Inhaler

Click to download a printer-friendly version. (89 KB pdf)

Click to download a printer-friendly version in Spanish. (90 KB)

Diskus inhalers are used to deliver long term control medicines into the lungs. Use a diskus inhaler as instructed by health care providers. Long-term control medicines should be taken every day, like a vitamin. They work slowly, over several weeks, to get rid of swelling and mucus in the lungs.  Once the swelling and mucus is gone, these medicines keep the swelling and mucus from coming back. Long-term control medicines do not help during asthma flare-ups.
1. While holding the diskus flat (horizontally), push the grip open until the mouthpiece appears and snaps into place.
2. While holding the diskus flat (horizontally), push the inside lever away until you hear and feel a click.
3. Breathe out.
4. Place your teeth on the mouthpiece and close your lips.
5. Breathe in deeply and forcefully, holding the inhaler horizontally.
6. Hold your breath for 10 seconds.
7. Close when done.
8. When the dose counter gets to 10, call for a replacement. The last five doses are in red.

Page Up

Using an Asmanex Inhaler

Click to download a printer-friendly version. (77 KB pdf)

Click to download a printer-friendly version in Spanish. (78 KB)

Asmanex® inhalers are used to deliver long term control medicines into the lungs. Use an Asmanex inhaler as instructed by health care providers. Long-term control medicines should be taken every day, like a vitamin. They work slowly, over several weeks, to get rid of swelling and mucus in the lungs. Once the swelling and mucus is gone, these medicines keep the swelling and mucus from coming back. Long-term control medicines do not help during asthma flare-ups.  Asmanex inhalers do not need to be primed.
1. Hold Asmanex upright.
2. Twist the cover and lift off.
3. Breathe out naturally.
4. Put the Asmanex inhaler between your teeth, close your lips and breathe in quickly and deeply.
5. Hold your breath for about 10 seconds.
6. Breathe out.
7. If your doctor tells you to take more than one puff, repeat steps three through six.
8. Twist closed when done.
9. The Asmanex inhaler has a counter to tell you when you are running low on medicine.  When the counter says 10, call for a refill.

Page Up

Using a Flexhaler Inhaler

Click to download a printer-friendly version. (131 KB pdf)

Click to download a printer-friendly version in Spanish. (134 KB)

Flexhaler® inhalers are used to deliver long-term control medicines into the lungs. Use a Flexhaler inhaler as instructed by health care providers. Long-term control medicines should be taken every day, like a vitamin. They work slowly, over several weeks, to get rid of swelling and mucus in the lungs. Once the swelling and mucus is gone, these medicines keep the swelling and mucus from coming back. Long-term control medicines do not help during asthma flare-ups.
The Flexhaler must be primed before using it for the first time only:
• Hold upright. • Open the Flexhaler. • Twist and click two times to “prime.”
Using the Flexhaler after it has been primed:
1. Hold Flexhaler upright.
2. Open the Flexhaler.
3. Twist the grip fully to the right and then back to the left. Hear the click!
4. Breathe out naturally.
5. Put the Flexhaler between your teeth, close your lips and breathe in quickly and deeply.
6. Hold your breath for about 10 seconds.
7. Breathe out.
8. If your doctor tells you to take more than one puff, repeat steps three through seven.
9. Close when done.

Page Up

Using a Nebulizer

Click to download a printer-friendly version. (138 KB pdf)

Set up the Nebulizer:                                                                                             

• Set machine on a hard, level surface.
• Plug the machine into an electrical outlet, if needed.
• Wash your hands with soap and water.
• Assemble equipment.
• Put the medicine in the nebulizer cup.

Giving a Nebulizer Treatment:

• Have the person sit straight up.
• Put the mouthpiece in the mouth, between teeth, and close the lips  (If using a mask, cover mouth and nose with the mask).
• Turn the machine on.
• Keep the nebulizer medicine cup in an upright position.
• Take slow, deep breaths through mouthpiece  (When using mask, encourage breathing through mouth, if possible).
• Hold each breath for 10 seconds, then exhale slowly through the mouthpiece.
• The treatment is done when all the medicine is used and no mist can be seen (you may need to tap the side of the medicine cup during treatment).
• Wash face if using a mask to prevent rash.

Nebulizer Cleaning and Storage:

• Take the nebulizer apart.
• Set tubing aside.
• Do not soak, wash, or rinse tubing.  Replace if it becomes cloudy, discolored, or wet inside.
• Wash the medicine cup, mouthpiece and mask with warm, soapy water.
• Rinse the medicine cup, mouthpiece and mask in warm water.
• Let all pieces air-dry on a paper towel.
• When completely dry, store pieces in a plastic bag or container.