There is a different underlying cause, not related to asthma or medication

Dr. Christou: This is unlikely. While it’s important to avoid immediately blaming medications for new symptoms, the temporal relationship between her inhaler use and onset of tremor makes this option less likely. Additionally, she has no other systemic symptoms (e.g., fever, weight loss) or neurological symptoms that might suggest an alternative diagnosis (e.g., anxiety disorders or essential tremor). Her presentation fits well within the known side effect profile of medication.

As clinicians, it’s critical to keep an open mind, but in this case, the simplest and most plausible explanation is a drug-related adverse effect. Go back and try again!