I've been using inhalers for ages. The trick with it is to time your breathing as you release the "puff". At first, I would do several breaths so I could release as I inhaled. That way it gets to the deepest reaches of your lungs. The newer inhalers, which had to do away with the propellant they were using before, don't dispense as much medication as the "old" ones. I find at times I need to use more than the 2 puffs to get the needed benefit. Too much of the albuterol can give the shakes tho. But if it is the choice of breathing or shakes, I choose breathing with shakes.
If you aren't getting the needed relief with an inhaler, you may need to go on to using a nebulizer. That gives the medication in a mist which you can more easily get into your lungs. It takes time to do the nebulizer, but it gives you more control of treatments.
One of the most important tools we can use is to learn to use a peak flow meter. It helps to use this before you do an inhaler or nebulizer. Then, take a reading afterwards. That way, you can help your doctor to treat you the best way. It helps to use a type of calendar to register your pfm and then take this with you when you go see your pulmonologist.
Take care and give your body a little time to absorb the medication from the inhaler or nebulizer. That way, you are letting your body deal with one thing at a time.
Sally