Reordering Metered Dosed Inhalers

Metered doses are measured amounts in a container. The manufacturer measures the correct number of doses and then overfills the product to ensure that the correct number of medication doses are available to administer. For instance, albuterol inhaler has 200 metered doses in the container. To know when to re-order the albuterol, the nurse needs to record the start date on the package. Next, he/she can use the directions to calculate when the container needs to be replaced. If the order reads “1 puff 4 times daily,” the nurse will divide 200 doses by 4. The container will need to be re-ordered & replaced in 50 days. If the order reads “2 puffs 4 times daily,” the nurse will divide 200 doses by 8. The container will need to be re-ordered & replaced in 25 days. The nurse will always divide the number of doses in the container by the number of doses given each day. The number of doses in the container will be printed on the box.

All inhalers, some eye drops, and some nasal sprays are metered doses. If the package contains the wording “metered dose,” the nurse will re-order the medication based on the previous calculation. Sometimes nurses shake the container to determine if medication is left in the container. However, the manufacturer states that this is inappropriate, since they overfill the container to ensure the correct number of doses. This means that after giving all of the metered doses, there will be some product remaining in the container.This will not be enough to give a complete metered dose. The manufacturer states in the package insert: Do not shake the container to determine if medication is left but calculate the number of doses given to determine when to replace the container.