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Table 1 ATS guidelines on correct MDI use

From: Effectiveness of one-on-one coaching in improving pressurized metered dose inhaler (pMDI) technique among COPD patients: a prospective clinical study

1

Put the metal canister into the “boot” making certain it is seated correctly

2

Shake the inhaler several times. This mixes the propellant and medicine

3

Remove the cap off from the mouthpiece

4

Breathe out to the end of a normal breath

5

Hold the inhaler in its upright position (with the mouthpiece at the bottom)

6

Put the mouthpiece in your mouth, past your teeth and above your tongue. Close your lips around the mouthpiece so that the medication does not go in your eyes

7

While breathing in slowly and deeply through your mouth, fully press down once on the top of the metal canister of your inhaler

8

Hold your breath for 5 to 10 s

9

Breathe out slowly

10

If you take more than one spray, wait 15 to 30 s (or as directed in the package insert) before taking the next puff. Then repeat steps 3–9

11

Replace the cap on the mouthpiece after you are finished

12

If you are inhaling a steroid, rinse your mouth out with water, swish, gargle and spit