Spacers and technique

[GreatGateway]

I just read this while looking up any potential answer as to why my preventer inhalers don't help me:

"If you just use your inhaler without a spacer, then most of the medicine will end up in your mouth or in your stomach instead"

Now I do use a large volumatic spacer, but I can't help but think I've been doing my technique wrong after reading this? Exactly how would the meds end up in your stomach instead, and how likely is this with a large spacer? Also I noticed it is quite hard to inhale fast through the large spacer mouthpiece. Is that to help slow down my inhale?

[O2Trees]

Hi GG, I remember Open University research which my respiratory nurse was taking part in years ago found that even with good technique, only around 10% of medication, sometimes a little more, reaches the lungs. A spacer will improve this but I suspect by only a small amount. The rest has to go somewhere - if it hits the back of your throat then saliva will take it down to your stomach when you swallow.

[GreatGateway in reply to O2Trees]

Thank you - so it's normal for most medication not to make it regardless?

[O2Trees in reply to GreatGateway]

I don't know if the research has been updated to cover spacers, it would be interesting to know. Technique is important so if you worry about yours, then Id think a spacer would be useful.

[Hidden in reply to O2Trees]

I believe it's one of the reasons why we are urged to gargle and rinse out our mouths after we use our inhalers.

[O2Trees in reply to Hidden]

Good point

[Hidden]

Hello Greatgateway

Why do you want to inhale fast? The most important thing is to empty your lungs to make room for the med you will inhale: so exhale blowing a candle style and pull in your pelvic muscles, you will then inhale slowly and deeply, and then block for 10 sec

[Beth_19]

My consultant explained it to me this way. With evohalers (which is the ones you push upon) the medicine comes out at a speed of 60mph so no matter how fast you inhale the majority of the medication hits the back of your throat instead of being taken into your lungs.

With spacers the medication is discharged into a confined space thus allowing you to inhale steadily instead of sharply which is often required without it simply due to the force and speed of the inhaler mechanisms. Therefore get more of into your lungs. He advised if using an evohaler always use a spacer where possible. When taking the medication don't blow out your breath harshly beforehand but instead blow in a controlled outward breathe and then inhaler using the spacer in the same fashion.

He did also switch me to an accuhaler which is a powder form of the medication which has to be physically inhaled out of the device so more of it gets into the lungs.

If you are having issue with your technique you can ask the asthma nurse for advice and assitance.

[Matman in reply to Beth_19]

Great Info. Thanks.

[Matti21]

Reason for rinsing mouth afterwards the steroid ingredient in the inhaler can cause oral thrush. I prefer a volumatic and an mdi device, as after 54 years feel I can tell the difference between using spacer and not, and my respiratory nurse encourages volumatics or spacer devices to get more ingredients into the lungs. I suppose they'll all have different opinions and we'll all have the same as well as different approaches.