Dry Powder Inhaler – Multiple Dose
What is a Dry Powder Inhaler (DPI)?
A dry powder inhaler (DPI) is a type of hand-held portable device that deliver medication to your lungs. The device is breath-activated, and the medication is released only when you take a deep, fast breath into the inhaler. This type of inhaler does not require coordination of inhaler actuation with inhalation. Compared to the MDI, the DPI utilizes a capsule form of the drug, which will be shattered or aggregated into fine molecules when the patient inhales via the principle of aerodynamics. This device is intended for maintenance therapy among patients with COPD and Asthma. Examples of such inhalers are: Breezehaler, Handihaler, Ellipta, Diskus, Turbuhaler.
There are two types of DPI: a single dose inhaler and a multiple dose inhaler. In this video, we will teach you the use of multiple-dose inhaler. Multiple unit-dose device makes use of a drug pre-packaged into single-dose blisters in a multidose package within the device that is automatically loaded once the patient activates the device.
Parts of a DPI
We have three common multiple-dose inhaler devices: the Diskus, Turbuhaler, and Ellipta
The Diskus has several parts namely the thumb grip as a cover. When you open the device, you will see the mouth piece, lever, thumb grip and dose indictor. Inside the device are several wheels and strips that aggregates the capsule to molecules to be inhaled by the patient.
The Turbuhaler has the cover, brown grip, dose indicator and mouth piece. Inside the container are channels and inlets that functions to deliver the medication properly.
The Ellipta has the mouth piece on top, air vent in front, counter, and a cover that slides down. Inside are holding chambers and strips that utilizes the capsule inhaled by the patient.
How to use DPI
Drug delivery is highly reliant on the correct inhaler technique. Poor control of symptoms and frequent exacerbations are attributed to poor inhaler technique. When using a DPI, one must breathe in fast and deep. The most common critical errors encountered with the use of DPI are due to incorrect inhalation technique and not holding one’s breath after taking in the medication.
Getting ready to use:
Multi-dose DPIs such as the Diskus and Turbuhaler require priming before initial use to ensure that the dosing chamber is filled with the correct amount of medication. Each inhaler will have different priming instructions. For your safety, it is important to check the expiry date and dose counter of your multi-dose DPI before using it.
Using a multiple-unit DPI
STEP BY STEP GUIDE ON HOW TO USE MULTIPLE DOSE DPI (Diskus)
- Hold Diskus in one hand, and put the thumb of your other hand on the thumb grip.
- Push your thumb away from you as far as it will go. The mouth piece will appear and will click into place.
- Hold Diskus level with mouth piece facing you.
- Slide lever away from you as far as it will go. Once you hear a click, medicine is now ready. Do not tip the Diskus.
- Turn your head and breathe all the way out. Do not breathe out into the device.
- Put mouth piece between your lips and make a tight seal.
- Breathe in fast and deep.
- Remove Diskus from mouth and hold your breath for as long as you can up to 10 seconds. Turn your head and breathe out.
- Put your thumb on the thumb grip and slide it backward toward you as far as it will go. You will hear a click when it is closed.
- Rinse your mouth with water and spit the water out.
STEP BY STEP GUIDE ON HOW TO USE MULTIPLE DOSE DPI (Anoro and Ellipta)
- Open the cover of the inhaler. Slide the cover down to expose the mouth piece. You should hear a click and see that the counter will move. Your inhaler is now ready to use. DO NOT SHAKE the inhaler.
- While holding the inhaler away from your mouth, breathe out fully. Do not breathe out into the mouthpiece
- Put the mouth piece between your lips and close your lips firmly around it.
- Take 1 long, steady, deep breathing through your mouth. Do not breathe in through your nose. Do not block the air vent with your fingers.
- Remove the inhaler from your mouth and hold your breath for about 3 to 4 seconds.
- Breathe out slowly and gently.
- Close the cover of the mouth piece.
Using a multiple-unit DPI
For most DPIs, you only need to wipe the mouthpiece with a clean, dry, lint-free cloth. DO NOT RINSE OR SOAK YOUR DEVICE IN WATER.
Store in a cool dry place and replace your multiple dose inhalers once the counter reads zero.