Treatment of Exercise-Induced Asthma

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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