the other night I spiked and was shaking very bad- well I think I figured out what happened-- I used an ashma inhaler when I got home from dinner and it has abuterol, I remember now when I was first diagnosed in Nov. I was in the emergercy room later that week and was given a breathing treatment of 3 times what I usually take, on the way home I was shaking so bad I could hardly drive. I'm not taking this med at home again unless someone is with me.