Misuse of metered-dose inhalers: helping patients get it right

For patients who are severely impaired by obstructive lung disease, bronchodilator and anti-inflammatory medications increase airflow, enhance secretion clearance, and can potentially improve gas exchange. As a result of reduced symptoms, patients may be able to better tolerate activities of daily living and to increase endurance for activities that have personal value. Inhaled forms of these drugs, generally administered by MDI, are preferred to oral forms because they deposit directly onto the airways and cause fewer side effects. But to produce these benefits, inhaled MDIs must be used correctly. The need to evaluate MDI use by every patient, and teach correct technique when indicated, cannot be overemphasized. Metered-dose inhaler technique, practice guidelines for inhaled medications, and knowledge of inhaled medication drug classes and side effects should be required competencies for home care nurses.