Introduction [edit]. A carboxyl group consists of a carbon double-bonded to an oxygen and also bonded to a-OH group. Compounds with carboxyl groups are called carboxylic acids or organic acids. The carboxyl group can act as an acid when by donating a proton (H +) to a solution and becoming ionized.
It therefore makes perfect sense to use the bronchodilator first, wait a few minutes, and then to use the steroid inhaler, after the airways have been opened up and are more relaxed. This way, the steroid can penetrate the lungs more effectively, and get down to decrease inflammation in your smaller airways.
The inhaler is now ready for use. If the inhaler is not used for more than 3 days, prime the inhaler once to prepare it for use. If it not used for more than 21 days, prime the inhaler 3 times. To inhale ipratropium and albuterol, breathe out fully, trying to get as much air out of the lungs as possible.