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Asthma - Management
What advice should I give regarding using the spacer device?
- Drugs should be administered as single actuations into the spacer and inhaled with minimum delay after each actuation, repeating until the prescribed number of puffs has been given. The canister should be shaken between actuations.
- When multiple puffs are being given, as during exacerbations, there should be a short pause between puffs to avoid hyperventilation.
- Spacer devices should be washed before they are first used, and once a month thereafter. They should be replaced every 6–12 months.
Clarification / Additional information
- Plastic or polycarbonate spacers (including Volumatic®, AeroChamber®, and Nebuhaler®) should be washed in washing-up liquid and allowed to air-dry (i.e. without rinsing or wiping). Any residual detergent should be wiped from the mouthpiece.
[DTB, 2000; Rees, 2005; SIGN and BTS, 2009]
Basis for recommendation
- Multiple actuations of the metered-dose inhaler into the spacer before inhalation may reduce the proportion of the drug inhaled [DTB, 2000].
- Static charge builds up on the walls of the spacer, potentially reducing the output of medication from the spacer. Washing the spacer as advised reduces this charge for at least 4 weeks, increasing the delivery of drug to the lungs [DTB, 2000].
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