How to use the Discus

1. Hold the outer casing of the Discus in one hand whilst pushing the thumb grip away until a click is heard
2. Hold Discus with mouthpiece towards you, slide lever away until it clicks. This makes the dose available for inhalation and moves the dose counter on
3. Holding Discus level, breathe out gently away from the device, put mouthpiece in mouth and suck in steadily and deeply
4. Remove Discus from mouth and hold breath for about 10 seconds
5. To close, slide thumb grip back towards you as far as it will go until it clicks
6. For a second dose repeat steps 1-5

How to use a metered dose inhaler

1. Remove cap and shake inhaler
2. Breathe out gently
3. Put mouthpiece in mouth and at start of inspiration, which should be slow and deep, press canister down and continue to inhale deeply
4. Hold breath for 10 seconds, or as long as possible then breathe out slowly
5. Wait for a few seconds before repeating steps 2-4

How to use the Turbohaler

1. Unscrew and lift off white cover. Hold turbohaler upright and twist grip forwards and backwards as far as it will go. You should hear a click
2. Breathe out gently, put mouthpiece between lips and breathe in as deeply as possible. Even when a full dose is taken there may be no taste
3. Remove the turbohaler from mouth and hold breath for about 10 seconds. Replace the white cover

How to use a spacer device (e.g. Volumatic)

Multiple breath technique
1. Remove cap, shake inhaler and insert into device
2. Place mouthpiece in mouth
3. Start breathing in and out slowly and gently. (This will make a clicking sound as the valve opens and closes)
4. Once breathing pattern is well established, depress canister and leave device in same position as you continue to breathe (tidal breathing) several more times
5. Remove device from mouth
6. Wait about 30 seconds before repeating steps 1-5

Single breath technique
1. Remove cap, shake inhaler and insert into device
2. Place mouthpiece in mouth
3. Press canister once to release a dose of drug
4. Take a deep, slow breath in
5. Hold breath for about 10 seconds, then breathe out through the mouthpiece
6. Breathe in again but do not press the canister
7. Remove device from mouth
8. Wait about 30 seconds before repeating steps 2-7

How to use the Aerochamber

1. Remove cap
2. Shake inhaler and insert in back of Aerochamber
3. Place mouthpiece in mouth (or mask over mouth and nose)
4. Press the canister once to release a dose of the drug
5. Take a deep, slow breath in. (If you hear a whistling sound, you are breathing in too quickly)
6. Hold breath for about ten seconds, then breathe out through the mouthpiece
7. Breathe in again but do not press canister
8. Remove mouthpiece from mouth and breathe out
9. Wait a few seconds before a second dose is taken, and repeat steps 2-8

How to use your Handihaler

1. Open the dust cap by pulling it upwards. Then open the mouthpiece
2. Remove a Spiriva capsule from the blister (only immediately before use) and place the Spiriva capsule in the centre chamber. It does not matter which way the capsule is placed in the chamber
3. Close the mouthpiece firmly until you hear a click, leaving the dust cap open
4. Hold the Handihaler with mouthpiece upwards and press the green piercing button completely in once, and then release
5. Breathe out completely, please avoid breathing into the mouthpiece at anytime
6. Raise the Handihaler to your mouth and close your lips tightly around the mouthpiece. Keep your head in an upright position and breathe in slowly and deeply but at a rate sufficient to hear the capsule vibrate.Breathe until your lungs are full: then hold your breath as long as comfortable and at the same time take the Handihaler out of your mouth. Resume normal breathing. Repeat steps 5&6 once, this will empty the capsule completely.
7. Open the mouthpiece again. Tip out the used capsule and dispose.