### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi. I was diagnosed with asthma about 2 years ago and never used my inhalers so this is all a bit new to me. Today I ve needed my salbutamol a lot. About 4 times within the last hour twice. I am a bit worried. It feels as tho someone is holding my airway tightly. The salbutamol relieves for a period of time but it comes back again. Earlier this evening I think I had too much salbutamol as I got all jittery and shaking. I didn t get much asthma advice when I was diagnosed so don t no when I should start to panic really. I ve been coughing a lot the last few days and don t no if that s related. I ve counted my HR and its 104bpm. It s hard to count my own reaps but I think they are 26. Should I be concerned or carry on taking the salbutamol as I have been and it die down?

### output:

Hi Jocosity, Thanks for writing your query. After reading your post, it seems that you are having an acute attack of bronchial asthma and needs medical attention. Salbuatmol is a bronchodilator and needs to be repeated in severe attacks and can cause shivering in hands. It seems that in addition to albuterol, you may need a steroid inhaler for more relief from your symptoms. I would suggest that you should get yourself clinically examined by your doctor and start a steroid inhaler like fluticasone under medical supervision. You can also discuss with your doctor of replacing albuterol with palmetto, which has longer duration of action and needs less frequent administration. Also take an antihistamines like fenofexadine 120 mg once a day for some relief in cough. I hope this is helpful to you. Thanks.