Pressurized Metered-Dose Inhalers (pMDI)

The pressurized metered-dose inhaler (pMDI) is the most common inhaler used to manage obstructive lung diseases. Proper inhaler technique is key to ensure appropriate delivery of medications deep into the lungs. A range of factors impact a patient's ability to consistently and properly use pMDI. For optimal adherence to a treatment plan, patients must adopt a belief the inhaled medications are beneficial, convenient, and effective in managing symptoms and reducing risks of future acute exacerbations. Healthcare professionals (HCPs) must effectively educate patients to properly use pMDI using the “teach back” method and “return demonstration” to avoid critical errors. Common inhaler technique mistakes include the following: Not shaking the device for at least 5 seconds, inadequately emptying the lungs before inhaling the pMDI, actuating the device (when using the closed lip technique) before starting to breathe in, breathing in too quickly, not holding the breath for up to 10 seconds, and taking the next dose too quickly, without waiting 20–60 seconds. This chapter includes figures and videos to reinforce the steps to teach a patient to properly use the pMDI and emphasizes the importance of teamwork between patients and HCPs to improve outcomes of patients with obstructive lung diseases.