Table 2.
Common MDI and DPI inhaler checklists derived from committee guidelines and manufacturers’ instructions.
| MDI technique* | DPI technique |
|---|---|
| Expose mouthpiece/remove cap15,40–47 | Expose mouthpiece/remove cap48–50 |
| Canister shaken (if medication in suspension)15,40–42,44–46 | Cock the trigger or twist base (prepare medication)48–50 |
| If first use or if several days have elapsed since last use, prime inhaler by releasing actuations into the air43–46 | Inhaler is not tilted, tipped, or shaken after preparing dose49 |
| Hold inhaler upright40–47 | Exhale before inhalation48–50 |
| Exhale before actuating inhaler15,40–47 | Does not exhale into device48,50 |
| Actuate inhaler at the start of inhalation15,40–47 | Hold inhaler horizontally while inhaling49 |
| Inhalation takes place over 3–5 seconds, or slow and deep inhalation40–47 | Inhale quickly and deeply48–50 |
| Hold breath for 5–10 seconds15,40–47 | Hold breath for 6–10 seconds49 |
| Actuate only once per inhalation15,40–45,47 | Replace cap/click shut48–50 |
| If instructed to take a second puff, wait 15–30 seconds before second actuation15,40,44–46 | |
| Replace cap40,42–47 |
*
See validated checklist by Press et al.51 for a similar set of instructions for MDIs with the use of a spacer.