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Solomon Lutheran Church & School 305 W. Main Street, Woodpile, Ohio 43469 Phone: (419× 8493600 FAX: 4198492260 SelfAdministered Asthma Medication Student Name Date of Birth Student Address Name of
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How to fill out self-administered asthma medication:

01
Wash your hands thoroughly with soap and water before handling the medication.
02
Check the expiration date of the medication and ensure it is not expired.
03
Shake the medication inhaler or canister well before each use.
04
Remove the cap or cover from the mouthpiece of the inhaler.
05
Hold the inhaler upright and place the mouthpiece between your lips, creating a tight seal.
06
Tilt your head slightly back and exhale fully to empty your lungs.
07
Press down firmly on the inhaler to release the medication into your lungs as you breathe in slowly and deeply.
08
Hold your breath for 5-10 seconds to allow the medication to deeply penetrate your airways.
09
Breathe out slowly and remove the inhaler from your mouth.
10
If a second dose is required, wait at least 1 minute before repeating the process.
11
After use, replace the cap or cover on the inhaler to protect it from dust and debris.
12
Rinse your mouth with water or brush your teeth after using certain types of asthma medication to prevent mouth and throat irritation.

Who needs self-administered asthma medication?

01
Individuals diagnosed with asthma by a healthcare professional.
02
Patients who experience symptoms of asthma such as wheezing, coughing, shortness of breath, and chest tightness.
03
People who need regular or as-needed medication to manage their asthma symptoms and maintain control of their condition.
04
Individuals who have been prescribed self-administered asthma medication by a healthcare provider as part of their asthma management plan.
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Self-administered asthma medication refers to medication that can be taken by the patient themselves to manage their asthma symptoms.
Patients with asthma who need to use self-administered medication are required to fill out information about their medication usage.
Patients can fill out self-administered asthma medication forms provided by their healthcare provider, which may include details about the medication, dosage, frequency, and any side effects.
The purpose of self-administered asthma medication is to help patients manage their asthma symptoms and improve their quality of life.
Information that must be reported on self-administered asthma medication may include the name of the medication, dosage, frequency of use, and any side effects experienced.
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