Inhalation therapy implies the administration of drugs in the form of aerosols directly into the tracheobronchial tree. There are a wide variety of inhalation devices available for use in the treatment of asthma.

• The metered-dose inhaler (MDI) remains the most economical device in those patients who can use it.
• Large-volume spacers allow patients to inhale drugs from metered dose inhalers in their own time and can improve lung deposition in patients with poor technique. Addition of a mask to the spacer allows use of metered-dose inhalers in small children. Large-volume spacers also reduce oropharyngeal deposition of aerosol droplets. For this reason they are the device of choice for administering high dose inhaled corticosteoroids.
• Various dry powder devices (ex: Rotahaler), do not require the patient to coordinate actuation with inhalation. They are suitable for many of the patients who have difficulty with metered dose inhalers including children.

Step 1: Remove the mouthpiece cap and shake the inhaler well.

Step 2: Breathe out gently, place the mouthpiece in the mouth with lips closed around it.

Step 3: Begin brething in slowly but at the same time, press down on the inhaler canister.

Step 4: Continue breathing in slowly and steadily until the lungs are full.

Step 5: Hold your breath for 10 seconds or for as long as comfortable. Breathe out slowly.

Step 1: Insert a rotacap, transparent end first, into the raised square hole of the rotahaler.

Step 2: Rotate the base of the Rotahaler in order to separate the two halves of the rotacap.

Step 3: Breathe in as deeply as you can*. Hold your breath for 10 seconds. Breathe out slowly.

*Note: If you are breathing correctly, you will hear the soft rattling sound of the rotacap.

Step 1: Assemble your Spacer by fitting the two parts together.

Step 2: Shake the Inhaler. Fill the inhaler into the slot opposite the mouthpiece.

Step 3: Close your lips firmly around the mouthpiece.

Step 4: Release a dose of medicine into the Spacer and breathe in steadily and deeply through your mouth.

Step 5: Remove the Spacer and hold your breath for as long as comfortable. Breathe out slowly.

For Children below 3 years. Baby Mask can be used along with the spacer.

Step 1: Push the two halves of the Zerostat Spacer together firmly.

Step 2: Remove the mouthpiece cap of the inhaler. Shake the inhaler well.

Step 3: Fit the inhaler into the narrow end of the Zerostat Spacer.

Step 4: Place the mouthpiece cap over the other end of the Zerostat Spacer.

Step 5: Holding the Inhaler, press down on the canister to release a dose into the Zerostat Spacer.
Note: If a second dose is required, wait for at least one minute before repeating steps 2 to 6.

Step 6: Remove the mouthpiece cap. Close your lips firmly around the mouthpiece to create a good seal. Inhale deeply through your mouth from the Zerostat Spacer. Remove the Zerostat Spacer from your mouth and hold your breath for as long as comfortable. Breathe out slowly.