The term “exercise-induced asthma” is actually a misnomer because, although the condition appears in 90% of asthmatic patients, non-asthmatic individuals can suffer from it as well. The problem occurs when exercise induces the bronchi, or airways, to narrow, or constrict, making breathing difficult. Therefore “exercise-induced bronchoconstriction” is the more proper term.
Signs and Symptoms During Exercising
- Shortness of breath
- Cough
- Poor exercise performance
- Wheezing
- Chest discomfort
- Tiredness during physical activity
Triggers of Exercise-Induced Asthma
- Cold air
- Dry air
- Air pollution
- Chlorinated water
- Physical activities calling for long periods of deep breathing, such as racing
Prevention
- Exercise away from polluted areas, in parks or closer to lakes rather than inner city streets
- Wear a mask on cold days
- Perform physical activity in short bursts
Treatment
Short-term beta agonists are the most commonly prescribed treatment for exercise-induced asthma. Usually 1-2 puffs are inhaled just before exercise (~5-20 minutes before). However, the body can build up a tolerance to them if they are used excessively
Proventil HFA, Ventolin HFA (albuterol)
Xopenex HFA (levalbuterol)
Long-term corticosteroids are inhaled to lower inflammation in the bronchi can be especially helpful for asthmatics that have worsening asthma during ecercise:
- Flovent (fluticasone)
- Pulmicort (budesonide)
- Qvar (beclomethasone)
- Asmanex Twisthaler (mometasone)
Combination corticosteroids with long-acting beta agonists are inhaled to lower inflammation and open bronchi. They are an option for asthmatics with well-controlled asthma who routinely suffer from exercise-induced asthma attacks:
- Advair Diskus (fluticasone and salmeterol)
- Symbicort (budesonide and formoterol)
- Dulera (mometasone and formoterol)
Leukotriene modifiers lower inflammation in some patients are an option as well, and are taken orally two hours before exercise:
- Singular (montelukast)
- Accolate (zafirlukast)
- Zyflo (zileuton)
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