when and how to use spacers with metered-dose inhalers (MDIs)

Questions often come up about when and how to use spacers with metered-dose inhalers (MDIs).

Types of devices. The original open-tube spacers (OptiHaler, etc) just added some distance between the inhaler and mouth...to limit how much drug hits the back of the throat. This can reduce local side effects from inhaled steroids such as oral thrush and hoarseness...especially if rinsing the mouth isn't enough.

Valved holding chambers (PrimeAire, etc) are preferred. They have the benefits of a spacer...and also help simplify the "press and breathe" technique of using an MDI by "holding" the med and giving the patient a little more time to inhale.