Management of Exercise-Induced Asthma
Anne D. Walling
(Great Britain–The Practitioner, November 1999, p. 830.) Exercise triggers symptoms in up to 80 percent of persons with asthma. Several studies have reported that 3 to 13 percent of children and young adults have exercise-induced asthma. Although exercise-induced asthma causes distressing symptoms, many athletes with the condition are highly successful. In 1984, 11.2 percent of Olympic participants reported having episodes of exercise-induced asthma and more than 60 percent of these athletes went on to win Olympic medals. The pathogenesis of exercise-induced asthma may be related to changes induced by inspiration of cool, dry air. Symptoms of wheezing and breathlessness usually peak within 10 minutes of exercise cessation and resolve spontaneously within 20 to 60 minutes, depending on the severity of the attack. The diagnosis is generally based on history with a challenge test if necessary. The diagnosis is confirmed if forced expiratory volume in one second or peak expiratory flow after 10 minutes of exercise fall by at least 15 percent. The treatment of choice is with an inhaled b2 agonist 15 minutes before exercise. Inhaled steroids may be necessary in more severe cases. Physicians and athletes should be aware of sporting regulations; the International Olympic Committee currently bans epinephrine, most steroids and certain b2 agonists.
COPYRIGHT 2000 American Academy of Family Physicians
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