Table 4.

Common inhaler errors associated with specific devices (general errors in Table 2).

Device type	Brand	Common errors
DPI	Diskus®97,105,107,110–112	Reduced dose after preparation due to holding downward Shaking the device after dose preparation Lever not pushed back completely Not closing the device Not checking counter has decremented after inhalation
	Turbuhaler®92,97,105,107,110–113	Device not held upright when priming the device Base not twisted until it clicks
	HandiHaler®105,110,111	Failure to insert or remove capsule Not fully closing device capsule chamber Not piercing the capsule Capsule did not rattle Failure to press and release button Opening next blister when taking the capsule Not checking if powder left inside capsule chamber/no second inhalation
	Breezhaler® (Neohaler®)105,110	Failure to insert or remove capsule Placing a capsule directly into the mouthpiece Not fully closing device capsule chamber Not piercing the capsule and failing to release piercing buttons fully before inhalation Capsule did not rattle Failure to press and release buttons Pressing the two side buttons more than once Not opening the inhaler to loosen capsule when whirring noise absent When checking a stuck capsule, not loosening the capsule by tapping the base of the inhaler Not checking if powder left inside capsule chamber/no second inhalation Removing the empty capsule by touching capsule in the inhaler
	Genuair® (Pressair®)114,115	Not pressing the button all the way down before inhalation Not releasing the button before inhalation, or pressing the button during or after inhalation Inhaling when the control window is still red Stopping inhalation when a ‘click’ sound is heard Not repeating the inhalation even when control window is green Not replacing the protective cap
	Ellipta®110,111–114	No ‘click’ sound after sliding the cover open Shaking device upside down after a dose preparation Not closing the cover
	Aerolizer®116	Not perforating the capsule once and releasing the lateral trigger Not checking if powder left inside capsule chamber/no second inhalation
	Easyhaler®112,113	Failure to shake the device Device not held upright when priming the device Holding the plunger down when inhaling Not emptying the device when loading more than one dose
	Spiromax®92,113	No ‘click’ sound after opening the cap Inhaler not held upright when a dose is prepared Not holding device upright with mouthpiece down Shaking before or after dose preparation Not closing cap postinhalation and loading a new dose
	NEXThaler®117	Not holding device correctly during loading Not inhaling as rapidly and forcefully as possible (to overcome breath trigger threshold value)
SMI	Respimat®105,116,118	Lack of cartridge in the device Incorrect assembly of the inhaler Failure to twist the base Not pressing down the inhaler Incorrectly pressing for the number of puffs specified Problems with co-ordination of actuation and inhalation (late start of inhalation causes exhaled dose due to the slow mist generation) Inspiratory effort too high in combination with a low resistance, leading to too fast an inhalation

DPI, dry powder inhaler; SMI, soft mist inhaler.