10 Common Mistakes in Aerosol Medication Use

Using aerosol medication effectively can be tricky, but avoiding these 10 common mistakes can make a big difference in your treatment. Here’s a quick rundown:

Wrong Breathing Method: Inhale slowly and steadily (4–5 seconds) to ensure the medication reaches deep into your lungs.
Missing Spacer with MDIs: Always use a spacer to improve medication delivery and reduce side effects.
Not Exhaling Before Use: Exhale fully before inhaling the medication to maximize its effectiveness.
Wrong Device Setup: Assemble and prepare your device correctly according to the instructions.
Forgetting to Prime or Shake: Always shake and prime your inhaler to ensure an even dose.
Poor Device Cleaning: Clean your device regularly to maintain performance and prevent infections.
Bad Breath Timing: Press the inhaler and inhale simultaneously for proper coordination.
Not Holding Your Breath: Hold your breath for 5–10 seconds after inhaling to allow the medication to settle.
Poor Storage Methods: Store medications in a cool, dry place away from sunlight and extreme temperatures.
Using Broken Equipment: Regularly inspect and replace damaged or faulty devices.

Avoiding these mistakes ensures your medication works as intended, reduces waste, and improves your overall results. Proper technique, device care, and storage are essential for effective aerosol therapy.

Asthma how-to: How to use an inhaler with a spacer and …

1. Wrong Breathing Method

One common mistake when using aerosol medications is improper breathing technique. Many people take quick, forceful breaths, which can prevent the medication from reaching deep into the lungs. Instead, it often ends up in the throat or upper airways, reducing its effectiveness.

For metered-dose inhalers (MDIs), the key is a slow, steady inhalation lasting about 4–5 seconds. This allows the medication to travel deeply into the lungs. Here are two frequent breathing mistakes:

Taking quick, shallow breaths, which limit how well the medication spreads.
Breathing too forcefully, creating turbulence that keeps the medication from reaching the lower lungs.

When using an MDI, your breathing should be almost silent. If you hear a whistling sound, you’re inhaling too quickly. To fix these issues, try the following:

Practice with an empty inhaler: Focus on a slow, 4–5-second inhale and listen for quiet, controlled breathing.
Use a visualization technique: Imagine "smelling a flower" to help you maintain the right pace and depth.

These simple changes can make a big difference in how well your treatment works.

2. Missing Spacer with MDIs

Using your MDI without a spacer can reduce how much medication actually reaches your lungs. A spacer creates a chamber that slows down the aerosol, making it easier to inhale deeply and effectively.

Without a spacer, much of the medication ends up in your mouth and throat instead of your lungs. This not only decreases its effectiveness but can also lead to local side effects. Here’s how to use a spacer correctly to get the most out of your medication:

Attach the spacer securely to your MDI.
Shake the inhaler thoroughly before use.
Release a puff into the spacer’s chamber by activating the inhaler.
Inhale slowly and deeply through the spacer.
Hold your breath briefly to let the medication settle in your lungs.

For those using inhaled corticosteroids, a spacer is especially helpful in reducing side effects in the mouth and throat. Using it properly can make a big difference in how well your medication works.

3. Not Exhaling Before Use

A crucial step in using inhalers or nebulizers effectively is exhaling completely before use. Skipping this step is a common mistake. If your lungs are still partially filled with air, the medication can’t reach the deeper parts of your airways, which limits its effectiveness.

Follow these steps to ensure proper medication delivery:

Sit or stand upright with your head slightly tilted back.
Exhale fully until your lungs feel empty.
Place the inhaler or spacer mouthpiece between your lips.
Inhale slowly while activating the inhaler.

This method works for both inhalers and nebulizers. Make sure your exhale is gentle and natural – there’s no need to forcefully blow out air, as that could make you feel lightheaded or uncomfortable.

Practicing this breathing technique when you’re not having trouble breathing can help you build muscle memory. That way, even during flare-ups, you’ll instinctively follow the correct steps. Taking your time with this step ensures the medication reaches where it’s needed most.

4. Wrong Device Setup

Getting your device set up correctly is just as important as mastering your breathing technique. To ensure your medication is delivered effectively, always follow the manufacturer’s instructions when assembling and preparing your aerosol device. Before each use, check that all parts are properly connected and free from damage. If anything seems unclear, refer to the instruction manual or reach out to your healthcare provider for guidance. This step is key to making sure your medication works as intended.

5. Forgetting to Prime or Shake

It’s crucial to prime and shake your inhaler to ensure the medication is evenly mixed and delivered correctly. If you skip this step, the medication can separate from the propellant, resulting in an uneven dose.

Always check the manufacturer’s instructions for priming your inhaler. For new or unused devices, this usually involves shaking the inhaler well and releasing a few test sprays away from your face.

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6. Poor Device Cleaning

Skipping regular cleaning of your aerosol device can hurt its performance and create a breeding ground for microbes. This can clog parts of the device and increase the chance of infections. To avoid these issues, always check the device manual for instructions on taking it apart, rinsing it with warm water, drying it completely, and how often to clean it.

A dirty device doesn’t just lower the effectiveness of your medication – it also raises the risk of respiratory infections. Keeping your device clean and well-maintained helps ensure your medication works as it should and supports your respiratory health.

For more tips and resources on using aerosol medications and maintaining your device, check out Respiratory Cram. Just like using proper breathing techniques, cleaning your device is a key step to getting the most out of every dose.

7. Bad Breath Timing

Getting your breath timing right is key to using inhalers effectively. Poor timing can disrupt coordination with the inhaler, reducing how much medication actually reaches your lungs. Many people press the inhaler too early or too late, which means less medicine gets where it needs to go.

Here’s how to get it right with metered-dose inhalers (MDIs):

Start slow: Begin inhaling slowly through your mouth.
Activate and inhale: Press the inhaler as you continue to take a slow, deep breath.
Finish inhaling: Keep breathing in for about 3-5 seconds.
Hold your breath: Pause for 5-10 seconds to let the medication settle in your lungs.

If you’re using Respiratory Cram’s resources, they offer video tutorials that demonstrate these steps in detail. Watching these can make it easier to understand and practice proper timing.

The goal is to sync the inhaler’s release with a steady, deep breath. Missing this step can waste medication and make symptom relief less effective.

8. Not Holding Your Breath

One common mistake when using inhalers is forgetting to hold your breath after inhaling. Pausing for 5–10 seconds allows the medication to settle deep in your airways, ensuring better delivery and absorption. Along with proper breathing and device use, holding your breath is key to getting the most out of your treatment.

Here’s why this step matters:

Improved medication delivery: Particles settle deeper in the lungs.
Better absorption: Lungs take in more medication.
Less waste: Reduces the amount of medication lost during exhalation.

For dry powder inhalers (DPIs), this step is especially crucial because the particles need extra time to reach the deeper areas of your lungs. Similarly, during nebulizer treatments, pausing your breath occasionally can boost the effectiveness of the medication.

Respiratory Cram’s video tutorials show how to hold your breath properly, with demonstrations from trained respiratory therapists. Watching these can help you master the timing and technique needed to form good habits.

Keep in mind, breath-holding shouldn’t feel uncomfortable. If 10 seconds feels too long, even a 5-second pause can make a difference. The goal is to stay consistent with each dose.

To fine-tune your technique:

Inhale deeply and slowly while taking your medication.
Seal your lips tightly around the mouthpiece.
Hold your breath for a few seconds, counting to a comfortable number.
Exhale slowly through pursed lips.

Making this small adjustment can lead to better medication delivery and improved results from your treatment.

9. Poor Storage Methods

Storing medications the wrong way can lower their effectiveness and even make them unsafe. Factors like temperature, humidity, and sunlight can break down the active ingredients, impacting their stability and reliability.

Medications should be kept in a cool, dry place at room temperature – ideally between 68°F and 77°F (20–25°C). Be sure to avoid these common storage mistakes:

Bathrooms: High humidity can interfere with medication quality.
Cars: Temperature swings can damage active ingredients.
Direct sunlight: Prolonged exposure can degrade medications.
Heat sources: Avoid storing near radiators or heating vents.

Always follow the manufacturer’s storage instructions and pay attention to expiration dates. Proper disposal of expired medications is equally important to ensure safety.

For inhalers, store them upright with the cap on, and keep different medications organized and separate. Regularly check the dose counter to avoid running out unexpectedly.

When traveling, always pack inhalers in your carry-on bag. Checked luggage is exposed to extreme temperatures that can harm the medication.

For nebulizers, store the device separately from the medication vials. Keep vials in their original packaging until you’re ready to use them. Proper storage plays a key role in maintaining the effectiveness of aerosol medications, just like proper usage techniques.

If you’re a respiratory therapy student or professional, Respiratory Cram offers in-depth video tutorials and practice questions to help you master aerosol medication storage and handling.

10. Using Broken Equipment

Using damaged or faulty aerosol delivery devices can put your health at risk and reduce the effectiveness of your medication. Keeping your equipment in good condition is just as important as proper cleaning and using the correct breathing techniques.

What to Check

Mouthpieces: Look for cracks or damage. Even small issues can lead to leaks and incorrect dosing.
Dose Counters: Malfunctioning counters can cause problems like:
- Using an empty inhaler when you need it most
- Throwing away devices too early
- Taking inconsistent doses
Nozzles: Hold the device up to a light source. If the nozzle looks dark or has debris, it may be clogged.

For nebulizers, check the following:

Compressor: Listen for strange noises or weak output.
Tubing: Replace if it’s cracked or stretched.
Mask or Mouthpiece: Inspect for tears or wear.

What to Do If There’s Damage
If you notice any problems, replace the equipment right away. Don’t try to fix it yourself – this can affect sterility and performance.

To be prepared, keep a backup device and store replacement parts where you can easily find them. Build a good relationship with your equipment provider to ensure quick replacements when needed.

For students in respiratory therapy, learning how to maintain and inspect equipment is essential. Resources like Respiratory Cram offer helpful video tutorials to guide you through identifying issues and keeping devices in top shape.

Taking care of your equipment is just as important as using it correctly – it ensures your medication works as it should.