Put the cap on. Corrigan reports attending an open day at GlaxoSmithKline headquarters, outside the submitted work.Support statement: The Aerosol Drug Management Improvement Team (ADMIT) is a group of European respiratory physicians with a common interest in promoting excellence in the delivery of inhaled drugs for asthma and COPD. Breathe out gently to empty your lungs. Put the spacer onto the inhaler. A significant proportion (15 out of 80 in the quoted study) of very young children (<24 months of age) is unable to generate sufficient (subatmospheric) inspiratory pressure to open the unidirectional valve of various commercially available VHCs [Plastic/polycarbonate/polymer spacers/VHCs do not conduct electricity and are therefore susceptible to electrostatic charging of their inner surface [Metallic (steel or aluminium) spacers/VHCs and some plastic spacers/VHCs with an antistatic inner lining (made of electrostatic charge-dissipative material) do not need priming since they are conducting and do not accumulate electrostatic charge. Remove the cap. Shake the inhaler to mix the medicine. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. It should be made clear to the patient that the whistle is not intended to sound. Put the caps back on both. It also helps get the medicine into your lungs better. They should not be given a choice about having it. This does not work.Store your inhaler at room temperature. C.J. Using a spacer wastes a lot less medicine than spraying the medicine into your mouth. An asthma inhaler with a spacer can also help you if you’re having an asthma attack. This short clip shows you how to use a standard metered dose inhaler (MDI), often called a puffer, with a spacer. What’s surprising, is that QVAR is made by Teva, which traditionally makes “lower cost” generic medications.“Daddy, why can’t they put my asthma medicine in a spray-can like they do hair spray?”In 1955, a young girl asked her father a simple question and a few months later, the first MDI for asthma was developed.Can asking a simple question about asthma inhalers get us such quick results today?Teva did recently get approval for their AirDuo brand and generic inhaler.A combination of fluticasone propionate and salmeterol, AirDuo is similar to Advair. Some of the advice hereunder is therefore empirical and not based on clinical trial evidence, although there is evidence that poor maintenance and understanding of spacer/VHC etiquette impacts unfavourably on efficient delivery of inhaled medication [Spacers/VHCs are potentially subject to microbial contamination and, since they come into contact with mucous membranes, it has been argued that they should be cleaned, disinfected, rinsed and air-dried after each use [Spacers/VHCs fabricated with nonconducting plastic materials accumulate internal electrostatic charge, which may significantly reduce the drug aerosol available for inhalation [Washing and cleaning a spacer/valved holding chamber (VHC)“Priming” of the spacer/VHC by repeatedly firing aerosol from the pMDI into it without inhaling also reduces the electrostatic charge on the inner wall of nonconducting (plastic) spacers/VHCs. We present an extensive review of the literature to date pertaining to the rationale for using a spacer/valved holding chamber (VHC) to deliver inhaled therapy from a pressurised, metered-dose inhaler, a discussion of how the properties of individual devices may vary according to their physical characteristics and materials of manufacture, the potential risks and … 2. Updated by: Laura J. Martin, MD, MPH, ABIM Board Certified in Internal Medicine and Hospice and Palliative Medicine, Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Print the step-by-step instructions and keep them with your Asthma Action Plan.