Proper technique is important when using an inhaler

How a case of thrush has reminded me to examine my procedures

Caroline Gainer avatar

by Caroline Gainer |

Share this article:

Share article via email
Main banner for Caroline Gainer's column,

I’ve been suffering from a bad case of thrush, which has brought to the front of my mind the importance of correct procedures when taking my inhaled medications — as I must because of my chronic obstructive pulmonary disease (COPD). Thrush can be caused by not rinsing well after using an inhaler dispensing a corticosteroid, as well as poor dental hygiene in general.

I must confess that either or both of the above-mentioned causes may have led to this painful episode. I had a round with a stomach virus, and during that time I had mornings when I just got up, fed the dog and cat, took my medicine, and went back to bed, all without brushing and flossing my teeth. My evening routine didn’t include brushing and flossing, either, for at least one night, so poor dental hygiene may have contributed to my thrush. And because I felt so bad, I more than likely only half-heartedly rinsed my mouth after using my inhaler.

Thankfully, my dentist had nystatin (known by several brand names) on hand, so I started the 14-day regimen. Once I felt better, I started to examine my inhaler and rinsing techniques.

Recommended Reading
Main banner for Caroline Gainer's column,

Missed doses reminded me my inhaler is important for my COPD

Good inhaler habits

I’ve used both a dry-powder Ellipta inhaler as well as a metered dose inhaler with a spacer or AeroChamber. It’s important to use these devices correctly to receive the most benefit from the medication.

With the Ellipta, patients should inhale forcefully and rapidly to get the best benefit. The head’s tilt also makes a difference, to ensure the medication goes to your lungs and not just your mouth. A friend of mine has the best explanation of how to hold the head: She says to look up a wall to the point where it meets the ceiling. This movement tips the chin up and the head slightly back.

With the metered dose with the spacer, the idea is to breathe slowly so the chamber doesn’t whistle. The head should be tilted slightly back to open the throat so that the aerosol can enter the lungs.

An excellent video of the proper use of the Ellipta and the metered dose inhaler can be found in the COPD Pocket Consultant Guide app, which also has videos for other devices used to deliver COPD medicines. If you don’t have the app, the information is also available as part of the COPD Foundation’s educational videos on its website.

For whatever reason I have thrush, the result has prompted me to revisit how I use my inhaler. That’s probably a good idea for all of us, as we tend to get sloppy with our technique over time.

Note: COPD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of COPD News Today or its parent company, Bionews, and are intended to spark discussion about issues pertaining to chronic obstructive pulmonary disease.


David A Sylvester avatar

David A Sylvester

Great tips Caroline. Thanks👍

Luann Day avatar

Luann Day

Great reminder. I KNOW how to use all sorts of I halers. It I get lazy sometimes due to the routine of it all.

Shirley Birney avatar

Shirley Birney

Thrush occurs if you are using steroid medication. I've never had mouth thrush since I carried out the instructions precisely. I had to endure oesophagus thrush because there is no way one can rinse the oesophagus. Have refused to inhale steroid based puffers ever since.

Audrey Stefanowitz avatar

Audrey Stefanowitz

I have never gotten thrush and have used several different inhalers over the years. I am currently on Breztri twice a day and rinse well and gargle well after each use.

Debra Pagani avatar

Debra Pagani

I had thrush very frequent. use nysatin on a regular dosage.I found no matter what I did I still ended up with thrush. dr told me to try rinse with salt water changed me to trelegy once a day., better than 2x aday.

Debra Terrill avatar

Debra Terrill

How do I stop osteoporosis from progressing so fast

Caroline Gainer avatar

Caroline Gainer

You should consult your physician about the osteoporosis. There are injections and medications taken by mouth that can aid in slowing down the progress and I have been able to build back lost bone mass.


Leave a comment

Fill in the required fields to post. Your email address will not be published.