6.12. Steps and procedures for the different routes of Medication Administration (Inhalation).


Inhalation: inhalers


  • Spacing and proper sequence of the different inhalers is important for maximal drug Effectiveness;
  • The prescribing practitioner may specifically order the sequence of administration if multiple inhalers are prescribed or the pharmacy may provide instruction on the medication label or MAR;
  • Wait at least one minute between puffs for multiple inhalations;
  • The client should be in a sitting position. Wash hands, apply gloves;
  • Grasp the medication dispenser and remove the mouthpiece cover;
  • Read instructions on inhaler to determine if medication is to be shaken;
  • Hold the dispenser’s mouthpiece according to package directions.
  • Instruct the client to exhale, and, on the count of three, to breathe in deeply as you administer the medication, then hold their breath for as long as possible, before exhaling;
  • It is best to have clients rinse their mouth after administering inhalants. Many times, inhalants taste bitter or can cause thrush;
  • Using an alcohol swab, clean the mouthpiece or spacer before replacing the mouthpiece cover.


How to Use Spacers


  • Ask the client to sit up straight, or stand up, and lift the chin to open the airways. Remove the cap from the mouthpiece of the inhaler and shake the inhaler vigorously.
  • If you haven’t used the inhaler for a week or more, or it is the first time you have used the inhaler, spray it into the air before using it to check that it works;
  • Insert the inhaler mouthpiece into the hole in the end of the spacer (the inhaler should fit snugly and without difficulty – see below);
  • Instruct the client to take some deep breaths and then put your teeth around the spacer mouthpiece (not in front of it and do not bite it), and seal lips around the spacer mouthpiece, holding it between the lips;
  • Press down on the canister in the inhaler to spray one puff of medicine into the spacer;
  • Instruct to breathe in slowly and deeply, then hold a breath for 10 seconds or as long as is comfortably possible. Breathe out, then breathe in deeply again through the mouthpiece of the spacer and hold a breath. Client should take two deep-held breaths from the spacer for each puff from your inhaler;
  • If you need another dose, wait 30 seconds, shake your inhaler again then repeat steps 4 to 8;
  • Don’t spray more than one puff at a time into the spacer. This makes the droplets in the mist stick together and to the sides of the spacer, so client actually breathes in a smaller dose.


NOTE: Follow the manufacturer’s instructions for cleaning all of the above.