Ask a CHOC Doc: How do I properly use a spacer with my handheld inhaler?

Question: I suffer from asthma, and recently got a spacer for my handheld inhaler. How can I make sure I am using it properly? ­-Anonymous

Answer:

A spacer is a small device that can attach onto the mouthpiece of a handheld inhaler device via the inhaler adaptor that allows you to receive the correct dose of medication with each puff. The medication fills the inside of the spacer chamber (body) and allows you to have ease of inhaling the medication through the mouthpiece.

handheld-inhaler
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Once the inhaler dose has been administered, simply replace the cap over the mouthpiece and remove the oral handheld inhaler device from the inhaler adaptor port. Replace the cap over the mouthpiece of the inhaler device and store both at room temperature (68 – 77 degrees F or 20-25 degrees C) in a clean, dry area. To protect from moisture, store the handheld inhaler in a plastic zip-sealed bag.

Proper techniques to rinse mouth after using certain oral inhalers to prevent thrush:

There are certain oral handheld inhalers, referred to as inhaled corticosteroids or steroid inhalers, that can increase the risk of developing oral thrush, a fungal infection in the mouth. Thrush looks like a white, patchy rash inside the mouth and on the tongue, which can be painful and requires an anti-fungal medication to treat it. If you are prescribed a steroid oral inhaler, it’s recommended that you rinse your mouth with water and spit after each dose of the inhaler. After rinsing your mouth with water, it is best to also brush your teeth. By following these easy steps, the risk of developing this is significantly reduced.

oral-thrush
Image: Oropharyngeal / oesophageal candidiasis (oral thrush). www.mymed.com (2019)

If you have specific questions about your inhaler, consult your primary care doctor.

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-Dr. Violet Valencia, clinical pharmacy resident at CHOC Children’s Hospital

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Breathmobile Celebrates 15 Years Serving Orange County Kids

Just in time for National Asthma and Allergy Awareness Month, CHOC Children’s is pleased to celebrate the CHOC Breathmobile’s 15 years of service to the community. As the only mobile asthma clinic dedicated to serving preschool and school-aged children in Orange County, this important resource removes barriers for children and their families who may be unable to access preventive asthma care. Additionally, the program is provided on certain days inside four of our CHOC primary care clinics for the convenience of our patients and families.

The Breathmobile team is currently working on a telehealth asthma consultation program to improve care for underserved children with asthma in pediatric practices throughout Orange County. The Breathmobile also serves as a training site for residents, fellows, nursing students and pharmacy residents.

CHOC Children's Breathmobile Anniversary Statistics

CHOC Children’s is grateful to Dr. Stanley Galant, medical director of CHOC’s Breathmobile, and the entire CHOC Breathmobile team for your unwavering commitment and dedication to your field and to our patient and their families.

Learn more about CHOC's Breathmobile

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Ask a CHOC Doc: What Medications Should I Have on Hand for my Child with Asthma?

Question: 

What medications should I always keep on hand for my child with asthma? -Anonymous

Answer:

All inhaled medication in children using a meter dose inhaler will require a valved holding chamber, as well a mask for children less than 6 years. This is not required for dry powder inhalers. The child should have access to a reliever medication such as albuterol both at home and school. For preventative measures, those who suffer from asthma must have a controller medication such as an inhaled corticosteroid or an oral medication such as montelukast. These need to be taken on a daily basis for several months as directed by your provider to be effective. At every visit, your provider should give you an asthma action plan so that you know when to take controllers and relievers, depending on how well your child is doing, as well as advice on when to seek medical help. A peak flow meter, an easy-to-use breathing test for home use, can also tell you how well your child is doing, and is part of the asthma action plan.

-Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.

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Ask a CHOC Doc: How Can I Avoid Seasonal Asthma Triggers?

Question:

What are seasonal asthma triggers that I should be aware of? How can I avoid them, or treat symptoms of them? -Anonymous

Answer:

While seasonal allergies occur typically in the spring and fall, and are difficult to avoid, it is important to avoid playing outside when pollen counts are high, such as after the grass is freshly cut. Again, the flu vaccine can reduce flu-related asthma symptoms in the fall and winter months. Keep in mind also that the avoidance of indoor allergens, such as house dust mites, by using pillow and mattress impermeable covers, can reduce the effect of outdoor allergens, and non-allergic triggers.

-Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.

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Ask a CHOC Doc: How Can I Help Manage My Child’s Asthma Year-Round?

Question: 

How can I help manage my child’s asthma year-round? -Anonymous

Answer: 

In the CHOC Children’s Breathmobile program, we strongly emphasize the importance of taking measures to avoid potential indoor allergens such as house dust mites, cat and dog dander, cockroaches and mold. We also recommend avoiding non-allergic triggers such as environmental tobacco smoke, and high levels of air pollution. Respiratory viral infections such as influenza can also be a trigger, so getting the flu vaccine in the early fall is a must for all people who suffer from asthma.

dr-stanley-galant-asthma
Dr. Stanley Galant, a pediatric allergist at CHOC Children’s, specializing in asthma.

The appropriate use of medication also plays a major role in managing asthma. This includes the use of a medication such as albuterol for asthma symptom relief and for preventing exercise induced asthma if given 15 minutes beforehand. In patients with more ongoing chronic asthma symptoms or severe asthma exacerbations, referred to as persistent asthma, a preventive approach, which will require daily controller medication for months as determined by your provider, is necessary.

Dr. Stanley Galant, pediatric allergist at CHOC Children’s and medical director of CHOC’s Breathmobile

Learn more about CHOC's Breathmobile

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