How do inhalers work

Asthma - Differences in Inhaler Devices

What devices are there?

There are several devices available for inhaling asthma medication. They are to be used in different ways. Which device is best for you depends on many circumstances. This includes your skill and your preferences. Whether a child or an adult uses the device also plays a role.

The following devices can be considered:

»Dosing aerosol (spray)

In the case of a metered aerosol, the asthma medication is sprayed. It reaches the lungs in many tiny droplets or particles.

Shake the asthma spray vigorously before inhaling. Then exhale deeply, take the mouthpiece between your lips and hold it tightly.

As a rule, you trigger the spray ("stroke") by hand. The inhalation must be precisely coordinated with the spray: you should press and inhale deeply at the same time. It is important to breathe in slowly. Otherwise, active ingredient particles get stuck in the mouth and throat and do not reach the lungs.

Then take the device out of your mouth and hold your breath for 5 seconds. Otherwise, you may breathe out the drug particles again and they will not be deposited in the lungs. Then breathe out slowly through your lips, which are almost closed.

If you cannot cope with a conventional spray, there are so-called spacers as an aid. For children up to 5 years of age, experts generally recommend a spacer.

Place the spacer on the mouthpiece. The drug first reaches a chamber from which one inhales.

» Powder inhaler

These devices come in several forms. They contain a powder. It is important to exhale before inhaling. Be careful not to breathe into the device. Otherwise the powder will clump together.

Unlike sprays, you don't have to press and inhale at the same time. However, when you breathe in, you need a lot more strength: you should breathe in hard and quickly. Only then do the powder particles change in such a way that they reach the lungs. Then take the device out of your mouth and hold your breath for 5 seconds. Then exhale slowly through your lips, which are almost closed.

Not everyone has enough breathing force. Therefore, a powder inhaler is not suitable for smaller children or if they have an asthma attack

» Nebulizer

A nebulizer is an electric inhaler device.

To inhale, use a mouthpiece. Children up to about 2 years of age are given a mask. You should first breathe in the mist slowly and deeply. Then you breathe out into the mouthpiece or mask.

Inhaling takes longer than with other devices. Then the device parts must be cleaned and dried so that no germs accumulate. Also, most nebulizers are too big to be used on the go.

What can I do myself?

Only with the right technique can the drug reach your lungs and work well there. You or your child should learn the inhalation technique for your device. Your treatment team should show you how to use the device. You can practice inhaling together. The pharmacy will also explain how your device works and show you how to use it. Further information can be found in the package insert. You can also find information about the inhalation devices on the website of the Deutsche Atemwegsliga e. V .:

You can also take part in a training course. Here you can find out, for example, how to deal with your illness and what to do in an emergency.

Above all, however, your doctor will support you. Let yourself be explained:

  • what advantages or disadvantages the inhalation devices have;

  • why the recommended device is right for you or your child;

  • which protective caps or covers to remove before use;

  • how to hold the device;

  • how to breathe when you inhale;

  • why with powder inhalers and sprays it is important that you hold the device away from your mouth when you breathe out;

  • whether and how you should clean the device;

  • how to store the device;

  • whether, when and how you need to refill the device;

  • whether and when the device needs to be replaced.

Even if you use the device every day, errors can creep in. Therefore, show your doctor how to use the device more often - that way you are on the safe side.

September 2020, published by the German Medical Association and the National Association of Statutory Health Insurance Physicians