List the typical sequence for using an MDI with a spacer for a single puff.

List the typical sequence for using an MDI with a spacer for a single puff.

• A. Exhale after inhaling, then actuate inhaler multiple times
• B. Inhale quickly, press inhaler and inhale rapidly, hold breath for 2 seconds, exhale
• C. Exhale fully, place spacer in mouth, actuate once while starting a slow inhalation, continue inhaling slowly, hold breath for 5-10 seconds, exhale slowly
• D. Place spacer in mouth, inhale rapidly, actuate, inhale again

Answer: (C)

The key idea is to optimize deposition by coordinating actuation with a slow, controlled inhalation when using an MDI with a spacer. For a single puff, you want to exhale fully first, place the spacer in the mouth, then actuate the inhaler once at the start of a slow inhalation. Continue inhaling slowly to draw the aerosol into the lungs, and after finishing the inhalation, hold your breath for about 5 to 10 seconds to give the medication time to settle in the airways, then exhale slowly. The spacer helps by slowing and delivering the spray, reducing the need for perfect timing and decreasing deposition in the mouth and throat. Why this sequence fits best: actuating once at the beginning of a slow inhalation ensures the aerosol is carried with the inhaled air into the lungs, rather than being released too early or too quickly. Holding the breath for a short period improves particle settling in the airways. Exhaling fully beforehand and exhaling slowly afterward keeps the technique consistent and comfortable. Other sequences fall short because they involve rapid inhalation, multiple actuations, insufficient breath-holding, or not coordinating actuation with the start of a slow inhalation, all of which reduce lung deposition and increase oropharyngeal deposition or wasted medication.

The key idea is to optimize deposition by coordinating actuation with a slow, controlled inhalation when using an MDI with a spacer. For a single puff, you want to exhale fully first, place the spacer in the mouth, then actuate the inhaler once at the start of a slow inhalation. Continue inhaling slowly to draw the aerosol into the lungs, and after finishing the inhalation, hold your breath for about 5 to 10 seconds to give the medication time to settle in the airways, then exhale slowly. The spacer helps by slowing and delivering the spray, reducing the need for perfect timing and decreasing deposition in the mouth and throat.

Why this sequence fits best: actuating once at the beginning of a slow inhalation ensures the aerosol is carried with the inhaled air into the lungs, rather than being released too early or too quickly. Holding the breath for a short period improves particle settling in the airways. Exhaling fully beforehand and exhaling slowly afterward keeps the technique consistent and comfortable.

Other sequences fall short because they involve rapid inhalation, multiple actuations, insufficient breath-holding, or not coordinating actuation with the start of a slow inhalation, all of which reduce lung deposition and increase oropharyngeal deposition or wasted medication.