Brief Answer: Xray Chest , Spirometry. Tiotropium not steroid Detailed Answer: Dear Sir, Thanks for writing to us. See bronchial asthma , COPD , are different diseases. If onset is late , there can be a confusion between the two. If your symptoms started after you moved from one place to another , changes of allergic bronchitis/rhinitis is more. Also since you are wheezing , it again goes in favor of allergic bronchitis or bronchial asthma. If you have been smoking for long and you have cough with expectoration for at least 3 months in a year for at least 2 consecutive years , it's defined as Chronic Bronchitis (COPD). It's not difficult to make diagnosis. Get your Chest X-Ray , Spirometry with reversibility , Absolute Eosinophil count , ESR. This would clear most of the picture. Now coming to your question , however , corticosteroids are used for allergic reaction , but rarely a patient can be sensitive to corticosteroids. Tiotropium bromide is an anti cholinergic drug , it has no relation with steroids but used for treatment of COPD , Asthma. I want to bring it to your notice because you have essential tremors , that drugs like beta agonist (salbutamol) also causes tremors , so always mention this to your doctor. I hope i am able to solve your query , if you have any further query , you may ask me.

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