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Asthma/Shaky hand while taking inhailer


Dear Sir,

Good morning,

My brother is just 19 years old and he is suffering from asthma. We have visited many doctor over here in Nepal and almost all suggested to take an inhaler.
during the time we have not allowed him to take inhaler as his handshakes for all the time when he takes inhaler.

so we were giving him homeopathic medicine in a regular manner by hwich there was no attack for almost 2.5 month. but last time he was exposed to the smoke which certainly made to difficult to breath he was not even able to take the inhaler. So we took him to the hospital in an immediate manner

At that time we all family member were there to take him to the hospital  but what if this kind of attack comes all of a sudden when is is alone.

please assist me how to take care of his situation and please tell me what can be done to reduce the shaky hand while taking inhaler.

please provide me best way of living after having asthma as well.

Thanking you


Hello Rujan,
   There are a couple of options for him. I'm assuming the present quick-relief inhaler he is using is albuterol (Pro-Air HFA, Ventolin-HFA or Proventil-HFA).
The first option is a variant of albuterol...levalbuterol (Xopenex-HFA). This has less side effects: shaking, racing heart, than the original product.
    Another option, and one that the doctor should test out in the office, is Ipratropium (Atrovent). It is in another family of drugs, and generally takes a few more moments to fully kick in. Note, the brand names I've listed may be different there.
   And as a reminder, he should always wait 1 minute between the first and second inhalations for best effect.
Hope this helps!



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Marc Rubin, RPh Asthma Educator


I have worked directly with patients as well as caregivers for over 30 years. Have made presentations throughout Illinois educating school nurses as well as the teaching and coaching staff of public schools about asthma, and how they should respond to these students needs. Presented a public education program on asthma through the US Department of Public Health. Specialize in helping guide asthmatic patients to take control of their disease in order to live a near-normal, fully active life.


Practicing pharmacist for 40 years, specializing in asthma and COPD for 12 years. Developed nationwide education to nurses, teachers and athletic coaches regarding asthma and exercise induced bronchospasm. In addition, and closer to home. my daughter has asthma, and my son has exercise induced bronchospasm. In addition, I serve on the boards and committees of a number of asthma organizations: Sports, Exercise and Fitness Committee of AAAAI, Population Health Committee and Sports Medicine Committee of ACAAI, Sports Medicine Committee of the World Allergy Association. Board of Directors of the Chicago Asthma Consortium, Board of Directors of the Christopher D. Redding Youth Asthma Foundation, as well as the advisory board of a medical education company, Emmi Solutions. Directly involved in the creation of public education programs for asthma, COPD and diabetes.

American Academy of Allergy, Asthma and Immunology / Sports Medicine Committee, American College of Allergy, Asthma and Immunology / Population Health Committee and Sports Medicine, American College of Chest Physicians, American Thoracic Society. World Allergy Association, Chicago Asthma Consortium / Professional Development Committee, Christopher D. Redding Youth Asthma Foundation, and Respiratory Health Association of Metropolitan Chicago: Development Committee for AE-C prep class, and presenter.

AAAAI PowerPoint on the new guidelines for EIB (Exercise Induced Bronchospasm), AAAAI Powerpoint on Asthma in School Setting for Teachers and Coaches, Annals of Allergy, Asthma and Immunology: Transition guide for teens with food allergies or asthma going out of the home to live independantly.

BScPharm, RPh, (NAECB Certified asthma educator in 2002), NIPCO Certified Respiratory Care Pharmacist

Past/Present Clients
Emmi Solutions, Chicago Next Level Health, Chicago

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