Which of the following is the optimal technique for use of a metered dose inhaler?
1. Actuating the inhaler with the mouthpiece 4 cm from the patient's opened mouth
2. Placing the inhaler in the mouth and closing the lips tightly
3. Holding breath for 5 to 10 seconds after inhalation
4. Not waiting between actuations
5. Inhaling the aerosol quickly
a. 1 and 3 c. 2, 3, and 5
b. 1, 3, and 4 d. 2, 4, and 5
ANS: A
If an adult patient positions the outlet of the pressurized metered dose inhaler approximately 4 cm (two finger widths) in front of an opened mouth and has a low inspiratory flow rate, this technique can increase the dose delivered to the lower respiratory tract from a range of approxi-mately 7% to 10% to 14% to 20% and can decrease the impact on the oropharyngeal region.
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