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Use steps

Metered-dose inhalers should be tested in the air to determine whether they can be used before the first use or when not in use for several days, depending on the item.

• Without the chamber

1. Remove the protective cover and connect the extension tube.
2. Shake the spray well before use.
3. Hold the inhaler (with the bottom facing up and the index finger on the bottom).
4. Exhale slowly.
5. Put the device into your mouth and close your lips tightly around the mouthpiece of the extension tube, but do not bite it.
6. While inhaling through the mouth, press the bottom of the inhaler with your index finger to release the spray. During which, breathe in steadily and deeply.
7. Move the inhaler away from the mouth and hold your breath for 5 to 10 seconds.
8. Exhale gently and return to normal breathing.
9. If further doses are required, wait 1 to 2 minutes and repeat steps 2 to 8.
10. Put the protective cap back on after use.

• With the chamber

1. Remove the protective cap.
2. Connect the thick side of the inhalation aid (chamber) with the mouthpiece of the spray.
3. Connect the protective cap with the thin side of the inhalation aid (chamber).
4. Shake the spray up and down and determine whether the joint is tight.
5. Press the bottom of the inhaler with your index finger. Follow the doctor's instructions for the number of presses and confirm that medicines are ejected into the inhalation aid (chamber).
6. Exhale first, remove the protective cap, and immediately inhale at normal breathing rate through one end of the inhalation aid.
7. After the liquid in the inhalation aid (chamber) has been sucked, remove the inhaler from the mouth, close your lips and hold your breath for 5 to 10 seconds.
8. Remove the inhalation aid (chamber) and put the protective cap back on.
9. Rinse the inhalation chamber with warm water frequently and air dry it immediately.

Use precautions

• In addition to the Alvesco inhaler, the rest should be fully shaken before each use.
• Never use force to open the container as there is pressure in the inhaler, and store it at room temperature (not above 50 ℃).
• The plastic mouthpiece is used with metered-dose spray solution products. Different products should not be mixed with the mouthpiece.
• After inhaling steroid-containing drugs, be sure to gargle to prevent oral candidiasis.
• Children or elderly people can use the inhalation aid (chamber) to help inhalation of medicines.

Cleaning

• Nozzles and mouthpieces should be cleaned with dry facial tissue or cloth at least once a week to avoid blocking, but not rinsed with water or placed in water.
• In case of obstruction, clean the mouthpiece section and use a fine needle to clean the outlet and the inlet.

Residual quantity judgment

• Berotec^® N 200 MDI metered aerosol, Berodual^® N 200 MDI metered aerosol: Put the canister in water and judge by its suspension.
• Seretide™ Evohaler 250, Seretide™ Evohaler 125: Do not place the canister in water. Check the scale on the inhaler to determine its residual doses.
• Foster, Alvesco: Affix the opening date to the bottle to calculate the remaining doses.

Drugs of this dosage form at our hospital

• Berotec^® N 100mcg/puff 200doses/Bot (Fenoterol 100μg each time)
• Berodual^® N 200dose/10mL/Bot (Ipratropium 21 μg + Fenoterol 50μg each time)
• Flixotide^® 50mcg Evohaler 120doses/Bot (Fluticasone 50μg each time)
• Seretide^® Evohaler 250 120doses/Bot (Fluticasone 250μg + Salmeterol 25μg each time)
• Seretide^® Evohaler 125 120doses/Bot (Fluticasone 125μg + Salmeterol 25μg each time)
• Foster^® 100/6mcg/puff 120doses/Bot (beclomethasone 100μg + formoterol 6μg each time)
• Alvesco^® 160 Inhaler 60doses/Bot (Ciclesonide 160μg each time)
• Spiriva Respimat^® 2.5mcg/puff 60puffs/Bot (Tiotropium 2.5μg each time)