Which principle(s) would be important to teach a patient about the use of a steroid inhaler? (SELECT ALL THAT APPLY)

A. When taking a steroid drug as well as a bronchodilator, the bronchodilator should be administered first: Administering the bronchodilator first opens the airways, allowing the steroid inhaler to reach deeper into the lungs and improve its effectiveness in reducing inflammation. B. Frequent oral hygiene is necessary: Steroid inhalers can leave residue in the mouth, increasing the risk of oral thrush and irritation. Regular brushing and rinsing help prevent fungal infections and maintain oral health. C. Hold your breath for 10 seconds during inhalation of the medication: Holding the breath allows the medication to settle in the airways and alveoli, enhancing absorption and therapeutic effect. It is an essential technique for proper inhaler use. D. Rinse and spit after inhalation of the medication: Rinsing the mouth and spitting after using a steroid inhaler reduces the risk of oral fungal infections and irritation caused by residual medication in the oral cavity. E. The inhaler should be used on a PRN basis only: Steroid inhalers are usually prescribed for regular, scheduled use to control inflammation, not just as needed for acute symptoms. Using them PRN reduces their effectiveness in preventing exacerbations.