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Clinical Reference Systems: Pediatric Advisor 10.0

Metered-Dose Inhalers (MDI): How to Use

The metered-dose inhaler (MDI) is a canister of medication that sprays a medicated mist into a person's airway. The MDI can be used alone or with a spacer device.

Several different types of MDIs are available, including bronchodilators (Proventil, Ventolin, or Alupent), inhaled steroids (Beclovent, Vanceril, Azmacort, or Aerobid), cromolyn (Intal), and ipratropium bromide (Atrovent). When a person is using more than one type of MDI, the bronchodilator usually is taken first.

There are several ways to use the MDI. The technique most often recommended is as follows:

  1. Shake the MDI vigorously.

  2. Hold the MDI so the mouthpiece is at the bottom.

  3. If you are using the MDI without a spacer, hold the mouthpiece 1 and 1/2 to 2 inches in front of the open mouth (about two- to three-fingers distance).

  4. Breathe out normally.

  5. Press the MDI down and cause it to spray while you breathe in slowly. (This is often called a puff.)

  6. Continue breathing in as slowly and deeply as possible.

  7. Hold your breath for 10 seconds or as long as is comfortable (this gives the medication time to work).

  8. Exhale slowly.

  9. Repeat steps 1 through 8 for a second inhalation (puff).

Written by the Asthma Task Force at The Children's Hospital, Denver.
Copyright 1999 Clinical Reference Systems