The dose counter will count down each time the mouthpiece cap is opened and closed. Before using for the first time, check the dose counter window to ensure that the inhaler is full and the number "200" is in the window. Powder for Inhalation (e.g., ProAir RespiClick, ProAir Digihaler) Additionally, the length of stay in the emergency department is shorter when a VHC was used. The method of delivery does not result in a significant difference in hospital admission rates in children seen in the emergency department or equivalent community setting. In children 2 years and older with acute asthma, the use of an MDI plus valved holding chamber (VHC) is as effective as nebulized therapy when appropriate administration technique is used. For children 4 to 5 years old, a pressurized MDI plus spacer is recommended a pressurized MDI plus spacer with face mask or a nebulizer with a face mask is an alternative. Nebulizers can transmit respiratory viral particles.-For infants and children up to 3 years of age, a pressurized MDI plus spacer with face mask is recommended a nebulizer with a face mask is an alternative. Delivery of a pressurized metered-dose inhaler (MDI) with a spacer with or without a mouthpiece may be preferred in adults and children with asthma exacerbation. Valved holding chamber (VHC) with aerosol inhalation: Other products should be discarded when the labeled number of actuations has been used or by the expiration date printed on original packaging whichever comes first. Ventolin HFA expires 12 months after medication removal from the foil pouch. Discard medication and inhaler after expired or once the labeled number of inhalations have been used, whichever comes first some products may have an inhalation counter. Allow the mouthpiece to air-dry before next use (e.g., over-night). Shake excess water from the mouthpiece and verify that all medication build-up has been rinsed away. Do not allow the medication canister to get wet. After removing the medication canister, wash the mouthpiece in warm running water. Clean the plastic mouthpiece of the inhaler at least once a week some manufacturers advocate daily cleaning. To avoid the spread of infection, do not use the inhaler for more than one person. Following administration, instruct patient to rinse the mouth with water to minimize dry mouth. Put the cap back on the mouthpiece after use. If prescribed more sprays, wait 1 minute and shake the inhaler again. The patient should hold breath as long as they can, up to 10 seconds, then breathe normally. After the patient has breathed in all the way, take the inhaler out of the mouth. Right after the spray comes out, release the canister. Push the top of the canister all the way down while the patient breathes in deeply and slowly through the mouth. Put the mouthpiece in the mouth and have patient close their lips around it. The patient will breathe out through the mouth and push as much air from the lungs as the patient can. Hold the inhaler as directed for the inhaler type. General administration instructions: Shake the inhaler well before each use. If a face mask is used, allow 3 to 5 inhalations per actuation. However, in general, children younger than 4 years require administration with a tight-fitting face mask and spacer/VHC device to achieve optimal delivery. The choice of using a mouthpiece versus a face mask with a spacer/VHC device must be made based on the skills and understanding of each individual patient. For patients of any age unable to coordinate inhalation and actuation, a spacer or valved holding chamber (VHC) should be used. When the inhaler has not been used for a prolonged period, or it has been dropped, prime by spraying 2 to 4 times into the air away from the face, according to the specific inhaler type. Prime the inhaler before the first use by spraying 4 times into the air, away from the eyes and face. Make sure the canister is firmly seated in the plastic mouthpiece adapter before each use. Instruct patient on proper inhalation technique see the specific product's "Instructions for Use" from the manufacturer. Administer using a calibrated measuring device.Īerosol inhalation (e.g., ProAir HFA, Ventolin HFA) Extended-release tablets: Swallow whole with the aid of liquids. Administer with food to minimize gastric irritation. For storage information, see the specific product information within the How Supplied section.
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