Introduction to Metered Dose Inhalers (MDIs)
Metered Dose Inhalers (MDIs) are a common method for delivering medication directly to the
lungs for conditions such as
asthma and
chronic obstructive pulmonary disease (COPD). They are portable, convenient, and effective when used correctly. As a nurse, understanding the proper use and education of patients regarding MDIs is crucial for optimal patient outcomes.
How Do MDIs Work?
MDIs consist of a pressurized canister containing medication, which is released in a fine mist when the inhaler is activated. This mist is inhaled into the lungs, where it exerts its therapeutic effects. The key components of an MDI include the canister, actuator, and mouthpiece.
Common Medications Delivered by MDIs
MDIs can deliver a variety of medications, including: Bronchodilators (e.g., albuterol, salbutamol) - used to relax and open airways.
Corticosteroids (e.g., beclomethasone, fluticasone) - used to reduce inflammation.
Combination inhalers (e.g., fluticasone/salmeterol) - contain both a bronchodilator and a corticosteroid.
Steps for Proper MDI Use
Proper technique is critical for the effectiveness of MDIs. Here are the general steps: Shake the inhaler well before each use.
Remove the cap and check for any foreign objects in the mouthpiece.
Exhale fully to empty the lungs.
Place the mouthpiece in your mouth and close your lips around it.
Press down on the canister to release a dose while inhaling slowly and deeply.
Hold your breath for about 10 seconds to allow the medication to settle in the lungs.
Exhale slowly and, if another dose is required, wait about 30 seconds before repeating the steps.
Common Mistakes and Troubleshooting
Patients often make mistakes when using MDIs, which can reduce the effectiveness of the medication. Common errors include: Not shaking the inhaler before use.
Incorrect timing between activation and inhalation.
Inhaling too quickly or too slowly.
Not holding breath long enough after inhalation.
As a nurse, it is important to observe patients using their inhalers and provide corrective feedback. Using a
spacer can also help improve medication delivery by reducing the need for precise timing between actuation and inhalation.
Patient Education and Nursing Role
Educating patients about proper MDI use is a key nursing responsibility. This includes demonstrating the correct technique, allowing patients to practice under supervision, and providing written instructions or videos for home reference. Additionally, nurses should assess patients' understanding and ability to use their inhalers correctly at each visit.Monitoring and Follow-Up
Nurses should regularly monitor patients for adherence to their inhaler regimen and evaluate the effectiveness of the treatment. This includes checking for improvements in symptoms, assessing for side effects, and ensuring that the inhaler is being used correctly. Follow-up visits provide an opportunity to reinforce education and make any necessary adjustments to the treatment plan.Conclusion
Metered Dose Inhalers are a vital tool in the management of respiratory conditions. Proper technique and patient education are essential to maximize their effectiveness. Nurses play a critical role in teaching, monitoring, and supporting patients in the use of MDIs to ensure optimal therapeutic outcomes.
