The experience of shaking or jitteriness after using an inhaler is a frequent side effect that many people encounter. This temporary trembling, often noticeable in the hands, can be unsettling but is generally considered a common reaction to the medication. Understanding the cause and having a plan to manage this effect can help reduce anxiety and ensure the focus remains on successful breathing.
Why Inhalers Cause Tremors
The primary cause of post-inhaler shaking lies in the mechanism of the medication, particularly the class known as beta-agonists found in rescue inhalers. These drugs, which are bronchodilators, relax the smooth muscles lining the airways in the lungs to open them up quickly by stimulating specific beta-2 adrenergic receptors.
While the medication targets the lungs, some is absorbed into the bloodstream and travels throughout the body, stimulating beta-2 receptors elsewhere. These receptors are also present in skeletal muscles, and their stimulation causes temporary muscle excitation. This systemic effect leads to the fine tremor or feeling of nervousness users commonly experience, often accompanied by a faster heart rate.
Immediate Steps to Reduce Shaking
When shaking occurs right after using the inhaler, the most effective immediate action is to remain calm, as anxiety can intensify the physical symptoms. The shaking is a temporary side effect that typically subsides quickly as the body processes the medication. Users should find a comfortable place to sit down and focus on steadying their breathing to help regulate their system.
Deep, slow breathing exercises can help counteract the jittery feeling by engaging the parasympathetic nervous system, which promotes relaxation. Sipping water can also help the body metabolize the medication more efficiently and provide a physical distraction.
Preventing Tremors During Future Doses
Preventing tremors focuses on maximizing the delivery of medication to the lungs and minimizing systemic absorption. Proper inhaler technique is foundational, ensuring the medication reaches the target airways instead of settling in the mouth or throat. This technique includes exhaling fully before use, inhaling slowly and deeply, and holding the breath for several seconds afterward.
The consistent use of a spacer device with a metered-dose inhaler (MDI) is a highly effective preventative measure. A spacer is a chamber that attaches to the inhaler, holding the medication cloud temporarily, allowing the user to inhale it more slowly and efficiently. Using a spacer significantly increases the amount of medication reaching the lower airways and reduces the amount deposited in the mouth and throat, lessening systemic side effects like shaking.
Consulting with a healthcare provider is important for long-term tremor prevention. If shaking is persistent, a doctor may suggest reviewing the frequency of use, as frequent reliance on a rescue inhaler suggests the underlying condition may not be well-controlled. The provider might recommend adjusting the dose, switching delivery methods, or exploring alternative long-term control medications to reduce the need for the quick-relief inhaler.
When Shaking Requires Medical Attention
While mild shaking is a common and expected side effect, certain symptoms warrant immediate medical consultation or emergency care. Severe or persistent shaking that does not begin to subside within a reasonable time frame should be reported to a doctor. Any new or worsening chest pain, a severely irregular heartbeat, or palpitations require urgent medical attention.
Other red flags include severe dizziness, confusion, or lightheadedness, which may indicate a significant systemic reaction. If breathing difficulty worsens after using the inhaler (paradoxical bronchospasm), or if signs of a severe allergic reaction such as swelling of the lips or throat occur, contact emergency services immediately.