Tremors, or shaky hands, can be an unsettling experience for those with asthma. While it may not be a commonly discussed side effect of asthma medications, it’s worth understanding why it occurs and how it relates to the body’s response to fear.
What Causes Tremors? A tremor is characterized by involuntary quivering or shaking of the hands or other body parts. In some cases, it can be a natural response to fear or anxiety. However, certain asthma medications can induce tremors as a side effect. These medications often mimic the body’s response to fear, activating the sympathetic nervous system (SNS).
The SNS plays a vital role in the body’s “fight or flight” response. When faced with a perceived threat, such as encountering a bear, the SNS triggers a series of reactions. It releases chemicals like adrenaline (epinephrine) into the bloodstream, which travel to various parts of the body to prepare it for action.
These responses include increased awareness, dilated airways for easier breathing, accelerated heart rate to pump blood faster, and muscle tension, which can manifest as trembling due to fear. This natural response enhances vigilance and prepares the body to respond effectively to a threat.
Asthma Medicines and Tremors Some asthma medications fall into a category known as sympathomimetic medicines. These medications mimic some or all aspects of the SNS response, leading to side effects like tremors. One of the earliest asthma treatments, epinephrine (adrenaline), discovered in 1901, was found to dilate airways effectively and became the first bronchodilator.
Epinephrine binds to beta-2 receptors in the lungs, causing airways to dilate, which is desirable for asthma management. However, it also binds to other receptors in the body, leading to unwanted effects like narrowed blood vessels, increased heart rate, and, importantly, tremors.
Modern Bronchodilators Pharmaceutical advancements since 1901 have led to the development of modern bronchodilators with stronger bronchodilator effects and reduced side effects. These medications have minimized or eliminated the undesirable effects of epinephrine, making them more suitable for asthma management.
Today, there are two main categories of bronchodilators for asthma:
- Short-acting bronchodilators (SABA): These provide rapid relief and are often referred to as rescue inhalers. Examples include albuterol and levalbuterol, and they typically last from 4 to 8 hours.
- Long-acting bronchodilators (LABA): These keep airways open over an extended period and are used in conjunction with inhaled corticosteroids to control asthma. They typically provide 12 to 24 hours of relief. Common examples include Advair, Symbicort, Dulera, and Breo.
Personal Experience For individuals with well-controlled asthma, the occurrence of tremors due to asthma medication is minimal and barely noticeable. However, if the rescue inhaler (SABA) needs to be used frequently, tremors may become more pronounced. Those using a LABA for asthma control may still experience slight tremors.
In many cases, these tremors are manageable and do not significantly impact daily life. They may only become noticeable in specific situations, such as public events. Overall, while tremors are an uncommon side effect of asthma medication, they are a reminder of the intricate interplay between these medications and the body’s physiological responses.
