Table 1 Steps in using metered dose inhaler device adapted from the National Asthma Education and Prevention Programmes of America (NAEPP)

1*

Shake the contents well

2*

Remove the cap

3

Hold the inhaler upright

4

Tilt the head back slightly

5*

Breath out slowly

6*

Open mouth with inhaler 1 to 2 inches away or in the mouth with the lips tightly sealed around it

7*

Begin breath in slowly and deeply through the mouth and actuate the canister once

8*

Hold breath for 10–20 sec

9

Exhale & wait one minute before the second dose

10

Shake again before the second dose

11

After use, replace the mouth piece cover