How to Use Your Dry Powder Inhaler

Some COPD medications can be taken in the form of a dry powder using a small, hand-held device called a dry powder inhaler (DPI). Dry powder inhalers deliver medication to the lungs as you inhale through the device. The DPI does not contain propellants or any other ingredients. It contains only the medication.

The Diskus (fig 1) contains 60 doses of medication. (Advair^®, Flovent^®, and Serevent^® are the brand names of the medication that might be prescribed for you.) It has a dose indicator that counts down the number of doses as you use them. Doses 5 through 0 are in red to alert you to refill your prescription. When the "0" appears in the dose indicator, throw away the Diskus and begin a new one.

Preparing the Diskus

1. Hold the outer case in one hand. Place the thumb of your other hand in the thumb grip. Push your thumb as far away from you as it will go. This action opens the Diskus to expose the lever underneath and locks the mouthpiece into position.
2. Hold the Diskus in a level position to prevent the medicine from dropping out. Slide the lever away from you until it clicks. This action loads the dose of medication. You will see the dose counter decrease by one.

Inhaling the medication

Once you have your DPI loaded, follow these steps to inhale the medication:

1. Turn your head away from the Diskus and breathe out as much air as you comfortably can.
2. Place the Diskus mouthpiece in your mouth and breathe in as steadily and as deeply as you can.
3. Remove the Diskus from your mouth and hold your breath for up to 10 seconds.
4. Close the Diskus by placing your thumb in the thumb grip and sliding the grip back toward you, over the mouthpiece. This action resets the inhaler so it is ready to use for the next treatment.

Caring for Your DPI

• Keep your dry powder inhaler in a dry place at room temperature.
• Never place the DPI in water.
• Never shake or breathe into the DPI.
• Never use a spacer device with the DPI.
• Unlike other inhaled medications, you might not taste, smell, or feel the dry powder. This might be different from what you are used to. As long as you are following the directions, you will get your full dose of medication.
• If you are using a corticosteroid medication, rinse your mouth and gargle after using the DPI. Do not swallow the gargle solution.

The Turbuhaler^® (fig 2) contains 200 doses of medication (the brand name is Pulmicort^®). There is a small, clear window on the barrel of the Turbuhaler that is a dose indicator. When a red mark appears at the top of this window, 20 doses remain and you should refill your prescription. When the red mark reaches the bottom of the window, throw away the Turbuhaler and begin a new one.

Preparing the Turbuhaler

When you obtain a new Turbuhaler, you must prime it before you can use it.

1. Hold the Turbuhaler upright to ensure proper loading of the medication.
2. Twist and remove the cover.
3. Twist the brown grip on the bottom fully to the right and then back again. You will hear a "click."
4. Repeat a second time. Your new Turbuhaler is now primed and ready to be loaded with a dose. (Remember, you only need to prime the Turbuhaler the first time you use a new one.)
5. To load a dose, continue to hold the Turbuhaler upright. You must hold the Turbuhaler upright to ensure proper loading of the medication. Twist the brown grip fully to the right and then back to the left. You will hear a click. The Turbuhaler is now loaded with a dose.

Inhaling the medication

1. Turn your head away from the inhaler and breathe out as much air as you comfortably can.
2. Place the device in your mouth and breathe in as quickly and as deeply as you can.
3. Hold your breath for up to 10 seconds.
4. Take the DPI away from your mouth and exhale slowly.
5. If more than one dose is prescribed, load another dose, and repeat steps 1 through 5 for each dose.
6. When your treatment is complete, replace the white cover and twist it completely to close.

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