Using Inhalers For COPD

If COPD is affecting your breathing, you'll usually be given an inhaler. This is a device that delivers medicine directly into your lungs as you breathe in.

But knowing how to use an inhaler correctly is essential for persons with COPD, said Sanjeev Kumar, a registered respiratory therapist at Franciscan Health Indianapolis.

“We often don't care because we are breathing unless and until we are really in the problem, feeling, ‘I can't breathe,’” he said. “So we take it for granted.”

Kumar, who works with patients with COPD, offers tips for improving the effectiveness of your inhalers for treating chronic obstructive pulmonary disease.

What Are The Types Of Inhalers?

Inhalers deliver medications to treat COPD. Often these are used with medications called bronchodilators to open up airways, relieve shortness of breath and help prevent COPD flare-ups. These drugs, usually taken with an inhaler, are the same type that people with asthma use during an asthma attack.

Bronchodilators include both beta-2 agonists (for example, albuterol or salmeterol) and anticholinergics (tiotropium and ipratropium) and come in two basic types -- short-acting and long-acting.

Short-Acting Bronchodilators

Short-acting bronchodilators acts quickly and for shorter use, and these inhalers are often prescribed to patients in initial stages of COPD. Lasting from 4 to 6 hours, the short-acting bronchodilators are used only when necessary to ease breathing.

“They are also called quick relief, or rescue inhalers,” Kumar said.  “When a patient gets the feeling that it's a rescue inhaler, ‘I should use it when I'm really short of breath,’ that's where the confusion begins.”

Long-Acting Bronchodilators

If you experience symptoms regularly throughout the day, a long-acting bronchodilator inhaler may be recommended. Long-acting bronchodilators last about 12 hours and are used every day. According to the Global Initiative on Chronic Obstructive Pulmonary Disease (GOLD), long-acting bronchodilators are more effective and convenient for treating COPD.

Steroid Inhalers

If you're still becoming breathless when using a long-acting inhaler, or you have frequent flare-ups (exacerbations), your physician may suggest including a steroid inhaler as part of your COPD treatment.

Steroid inhalers contain corticosteroid medicines, which can help to calm down the inflammation inside the airways. The GOLD guidelines do not recommend corticosteroids as a stand-alone therapy, but suggest that they may work as a step-up therapy in combination with long-acting beta agonists. A study published in the journal Chest found that these drugs may help prolong the lives of people with COPD. However, there is some risk that long-term use can weaken your bones and increase your risk of high blood pressure, cataracts and diabetes.

What Type of Inhalers Will I Need For My COPD?

“The way inhalers work depend upon the staging of COPD,” Kumar said. “One shoe cannot fit all of the patients, similarly, one inhaler cannot fit all the patients, just like any other disease. Consult your physician, if you feel that you your current inhaler is not helping you.”

Your provider may discuss whether you are understanding how to use your inhaler correctly, breathing techniques, or compliance with using oxygen, CPAP or BiPAP machines if prescribed. That may be discussed in the office or through an appointment with an outpatient respiratory therapist.

Am I Using My Inhaler Correctly?

Different inhalers require different techniques. Follow the instructions exactly and talk to your doctor if you have any questions or problems.

“Before you go and talk to your physician about switching your inhaler, ask, ‘Do I use my inhalers the way I should use it? Is the technique right?’” Kumar said. “If you have any doubt about how to use my inhaler, please consult the specialist. Ask them how to use it, and there should be no shame in asking again and again. When you take it, give it a moment or two and then slowly breathe up. Slow and deep and hold."

Slow breathing has its benefits for the body.

“One, you are getting more air because you’re being slow. It just like on the highway; one car slows down, there’s a cascade and the cars start slowing down,” Kumar said. “The moment I breathe slowly, it is heard by the other organs per se. The heart realizes, ‘Hey, I should slow down.’ Then our brain feels it, and the brain comes down. You breathe even calmer. The slower I breathe, the calmer I get.”