1. Cough up as much sputum as possible.
2. Shake the aerosol before use.
3. Hold the aerosol as indicated in the manufacturer's instructions (this is usually upside down).
4. Place the lips tightly around the mouthpiece.
5. Tilt the head backward slightly.
6. Breathe out slowly, emptying the lungs of as much air as possible.
8. Breathe in deeply and activate the aerosol, keeping the tongue down.
9. Hold the breath for ten to fifteen seconds.
10. Breathe out through the nose.
11. Rinse the mouth with warm water.
Steps 4 and 5