Therapy
Inhaled Corticosteroids
ÎÎAlthough ICS therapy can decrease the frequency and severity of EIB, its
use does not necessarily eliminate the need for additional acute therapy
with β2-adrenergic agonists or other agents. (A)
ÎÎInhaled corticosteroid therapy does not prevent the occurrence of
tolerance from daily β2-agonist use. (A)
Anticholinergic Agents
ÎÎAlthough ipratropium bromide has been inconsistent in attenuating EIB,
a few patients may be responsive to this agent. (A)
Methylxanthines, Antihistamines, And Other Agents
ÎÎDrugs in several other pharmacotherapeutic classes, including
theophylline, antihistamines, calcium channel blockers, β-adrenergic
receptor antagonists, inhaled furosemide, heparin, and hyaluronic acid,
have been examined for actions against EIB with inconsistent results. (B)
Nonpharmacologic Therapy
ÎPre-exercise warm-up may be helpful in reducing the severity of EIB. (A)
Î
ÎÎReduction of sodium intake and ingestion of fish oil and ascorbic acid
supplementation may be helpful in reducing the severity of EIB. (A)
Competitive and Elite Athletes
ÎÎEIB alone in elite athletes may have different characteristics than EIB
with asthma in elite athletes or EIB in the general population. These
divergent characteristics may include pathogenesis, presentation,
diagnosis, management, and the requirement by governing bodies to
obtain permission to receive pharmaceutical agents. (D)
ÎÎAirway inflammation in elite athletes may be related to the high intensity
of physical training, high minute ventilation, and inhalation of airborne
pollutants and allergens. (D)
ÎÎThe diagnosis of EIB, whether alone or with asthma, in elite athletes may
be difficult because history and presentation are not reliable. Objective
testing is necessary to diagnose the condition accurately. (A)
ÎÎIn general, the treatment of EIB in patients who have asthma is similar in
both recreational and elite athletes. However, the efficacy of therapy for
EIB alone in athletes at any level is not well established. (A)
