Spacers with pMDI- A Support to Inhalation Therapy
Table of Content
A correct inhaler technique is required for the medication to reach the lungs, while using a pressurized-metered dose inhaler (pMDI). Patients who cannot master inhaler technique will benefit from adding a spacer. Spacers are intended to make inhalers easier to use and deliver medication more efficiently.
Spacers are holding chambers that allow time for the patient to inhale the drug after a few seconds once it is released from the pMDI.
Spacers help the medication get straight to where it’s needed in lungs, with less medication ending up in mouth and throat where it can lead to irritation or mild infections.
Patients with co-ordination problems
1. Children and the elderly
2. Those who are prescribed high dose inhaled steroids
3. Patients with acute asthma requiring high-dose bronchodilators, as a substitute to nebulizers
4. Those who are prescribed anti-cholinergic drugs (to avoid the spray particles from reaching the eyes)
Fire only one puff into spacer at a time. For each puff, one can either:
- Breathe in slowly and deeply through mouth, thus inhaling the medicine through the spacer. Remove the spacer from mouth and hold breath for about 10 secs or as long as is comfortable. Breathe out slowly
- Alternatively keep lips firmly around the mouthpiece and continue to breathe normally three to five times through the spacer.
Patient should breathe in from spacer as soon as a puff is fired into it- To avoid any loss of medication.
Remember to shake inhaler before firing each puff.
Check if you have the steps right by watching a short video on how to use an inhaler and spacer correctly in https://www.ciplamed.com
Reference: Eur Respir J 2011; 37: 1308–1331
- To assemble the spacer, firmly push the two halves of the spacer together and rotate.
- Remove the cap from the mouthpiece of the inhaler. Shake the inhaler well.
- Insert the inhaler firmly into the opposite end of the spacer.
- Holding the inhaler, press down on the canister to release a dose into the spacer.
- Breathe out fully, through the mouth. Immediately remove the mouthpiece cap from the spacer and then close the lips firmly around the mouthpiece to create a good seal (do not bite). Breathe slowly and deeply through the mouth, thus inhaling the medicine through the spacer.
Remove the spacer from the mouth and hold breath for about 10 seconds, or as long as is comfortable. Breath out normally. Alternatively, keep lips firmly around the mouthpiece and continue to breathe normally three to five times through the spacer. If a second dose is required, wait for a minute, repeat steps 2 to 5.
Patient can continue to use Spacer daily for up to 6 months and then discard it and replace with a new one.
- Separate the two halves of the spacer by gently rotating and pulling them apart.
- Rinse both halves in clean water and then shake to remove excess water. A soap solution may be used.
- Wipe dry with soft cloth or leave it to air dry.
- Do not push cloth or object into the mouthpiece as it may cause damage.
- Do not clean with boiling or hot water as this will damage the spacer.
- Children should use the spacer under parental guidance.
- On usage, the Spacer may show some haziness. This does not affect its performance.
- Replace with a new one after 6 months of use
Remove the mouthpiece cap of the inhaler and shake it well
Insert the inhaler firmly into opposite end
- CREATE A GOOD SEAL
Place the mouthpiece in mouth. Close lips firmly (do not bite it)
- RELEASE THE DOSE
Press down the canister of the inhaler. One can see the dose released in the spacer
- INHALE THE DOSE AND HOLD BREATH FOR 10 SECONDS
Breathe in slowly and deeply through the mouth, thus inhaling medicine through the spacer. Remove the spacer from mouth and hold for 10 sec, or as long as comfortable. Breathe out slowly
Keep lips firmly around the mouthpiece and continue to breathe normally three to five times through the spacer. If a second dose is required, wait for a minute, repeat steps 2 to 5.
Administer one dose at a time. If a second dose is required, wait for a minute and then repeat steps 1 to 5.
FOR CHILDREN: Use under adult guidance.
For children below 4 years of age, a face mask (Baby Mask/Infant Mask) can be attached to the spacer to facilitate administration.
- Remove the inhaler from the spacer
- Soak the spacer for 15 minutes in mild soap solution. Agitate gently
- Take out the spacer, shake out the excess soap water and put it into clean water. Agitate gently.
- Shake out the excess water, air-dry in vertical position, preferably overnight, before putting it back into its container. Dry completely before using it again.
- Do not clean with boiling/hot water or directly under running tap water to avoid damage.
- Avoid drying in direct sunlight.
- Do not push any cloth or object into the mouthpiece to avoid damage.
- On usage, Pre-Assembled Spacer may become hazy, performance remains unaffected.
- Replace with new one after 6 months of use.
Disclaimer: The content presented here, is medically validated excerpts, for the use of Registered Medical Practitioners or health care professionals solely for knowledge up gradation and informational purpose. Any change in the treatment regime is totally in discretion of the Physician. No part of this may be reproduced, transmitted or stored in any form or by any means without prior intimation to Cipla.