Introduced more recently, and gaining in popularity, are dry powder inhalers (DPIs), in which medicine is in powder form. Like a metered dose inhaler, a precisely measured dose of medicine is delivered. The advantage is that it is breath-activated -- you breathe in the dry powder as you take a normal breath, whereas, in metered dose inhalers you must coordinate spraying the medicine at the same time you inhale. As with all inhalers, proper use and following instructions is necessary.

Types of Dry Powder Medication and Instructions for Use

Pulmicort Turbuhaler ®  |  Foradil ® Aerolizer Inhaler  |  Spiriva® Handihaler®

Pulmicort Turbuhaler ®

Before you use a new Pulmicort Turbuhaler® for the first time, you should prime it. To do this, turn the cover and lift off. Hold the Pulmicort Turbuhaler® upright (with the mouthpiece up), then twist the brown grip fully to the right and back again to the left. Now it is ready to use.

Loading a Dose:

1. Twist the cover and lift off.
   
2. In order to provide the correct dose, Pulmicort Turbuhaler® must be held in the upright position (mouthpiece up) whenever a dose of medicine is being loaded.
   
3. Twist the brown grip fully to the right as far as it will go. Twist it back again fully to the left. You will hear a click.
   
4. Turn your head away from the Turbuhaler® and breathe out. Do not blow or exhale into the Turbuhaler®. Do not shake the Turbuhaler® after loading it.

Inhaling the Dose:

1. When you are inhaling, Pulmicort Turbuhaler® must be held in the horizontal position.
   
2. Place the mouthpiece between your lips and inhale deeply and forcefully.
   
3. Remove the mouthpiece from your lips. Hold your breath for five to 10 seconds. Breathe out slowly through pursed lips.
   
4. If more than one dose is required, wait 30 seconds and repeat the steps.
   
5. When you are finished, place the cover back on the Turbuhaler® and twist shut.
   
6. Rinse your mouth with water. Do not swallow. Keep your Pulmicort Turbuhaler® clean and dry at all times.

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Foradil ® Aerolizer Inhaler

1. Pull the cap off the inhaler.
   
2. To open, hold the base of the inhaler firmly and turn the mouthpiece in the direction of the arrow.
   
3. Remove the capsule of powdered medicine from the blister pack. Do not remove the capsule from the pack until you are ready to use it.
   
4. Place the capsule in the capsule shaped compartment in the base of the inhaler.
   
5. Move the mouthpiece to the closed position.
   
6. Keep the inhaler upright and firmly squeeze the two blue buttons fully ONE TIME ONLY. This will make a hole in the powder capsule. Even though the capsule is now ready, the powder will not be released until you inhale it.
   
7. Breathe out completely.
   
8. Put the mouthpiece between your lips and tilt your head slightly back. Close your lips around the mouthpiece and breathe in steadily and deeply. As you breathe in, you will inhale the medicine into your lungs.
   
9. You should hear a "whirring" noise when you breathe in because the capsule spins around in the inhaler.
   
10. Hold your breath for approximately 10 seconds, and remove the inhaler from your mouth, and then breathe out.
    
11. Open the inhaler and check that the capsule is empty. If it is not empty, close the inhaler and repeat steps seven to 10.
    
12. Remove the empty capsule, close the mouthpiece and replace the cap.

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Spiriva® Handihaler®

Directions for proper use:

1. Remove capsule from foil blister immediately before use.
   
2. Place capsule in the capsule chamber in the base of the HandiHaler® inhaler.
   
3. Close mouthpiece until a click is heard, leaving dustcap open.
   
4. Exhale fully (do not exhale into inhaler).
   
5. Place mouthpiece gently between teeth, closing lips around inhaler.
   
6. Inhale deeply and hold breath for 5-10 seconds.
   
7. Remove inhaler from mouth before exhaling.
   
8. If any powder remains in capsule, repeat inhalation again.
   
9. Throw away empty capsule. Do not store capsule in inhaler and always keep inhaler and capsules dry.

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