Dr.Kamini Silvarajan MD/AAAM

Editorial Board: Dr.Kamini Silvarajan MD/AAAM

Exercise Induced Asthma Medications

Asthma related to exercises occurs if the airway becomes narrowed after the activity. The medical term for this condition is Exercise-Induced Asthma or Bronchoconstriction or EIB. Exercising is not considered as an etiology (cause) of asthma but it is one of the predisposing factors that trigger the attack.

An individual usually displays the symptoms of asthma and it worsens during or after the exercises. If the asthma is triggered by exercises, it is considered as mild recurrent asthma.

The clinical manifestations of exercise-induced asthma are chest tightness, cough, and shortness of breath. The symptoms occur approximately 10 to 15 minutes after exercising. These manifestations are resolved through resting for about 30 minutes to 1 hour. The condition develops more often when the person inhales cold air. This is because inhaling large amount of dry and cool air can affect the airways.

There are several ways on how to prevent EIB (Exercise-Induced Asthma). This includes medications such as: 

Rapid-Acting Bronchodilators

– It dilates the airway to improve the airflow. It also prevents the asthma attack. They need to have two puffs of prescribed inhalant (Albuterol) usually 10 minutes before exercising.

Cromolyn Na (Sodium)

– This form of inhalant (Intal) should be taken before exercising. Other times, it is combined with the rapid-acting bronchodilator. If this inhalant is taken through metered dose, the proper dosage for cromolyn Na is 2 puffs. It must be done at least 15 – 20 minutes before starting the activity. In America, the cromolyn sodium is available for nebulization.

– This medication also decreases the allergic cell activities. It has no underlying adverse reaction. However, it has lower efficiency compared to albuterol but most people with exercise-induced asthma prefer this medication because there are no side effects. 

Long-Acting Bronchodilators (LABAs)

The LABAs (Formoterol and Salmeterol) responds for longer time compare with rapid-acting bronchodilators. However, this type of medication is not advisable for single treatment. It must be used to modify the leukotriene or as inhaled glucocorticoid. It is taken for about 30 minutes (Salmeterol) or 5 minutes (Formoterol) before exercising. Take note that this medication should not be repeated frequently than 2x a day (every 12 hours). 

Leukotriene Modifiers

This type of treatment for exercise-induced asthma helps reduce the narrowing of the airway. It also works to reduce the production of mucus and inflammation of the bronchus and bronchioles. It is taken orally for once a day (Montelukast) or two times a day (Zafirlukast). It has few adverse reactions. Ideally, this should be taken regularly in order to prevent exercise-induced asthma. 

It is also considered as an alternative treatment in case the rapid-acting bronchodilators are not available. This is to prevent EIB for individuals who choose or require an all-day protection. People with difficulty in using inhalers prefer this type of medication, as well. 

The Montelukast is taken by people with EIB who are not used of daily medication. This drug must be ingested for about 2 hours before exercising. It provides 12-hour protection to the users and it should be taken only once in a day. 

It is highly recommended that people with EIB should consult their pulmonologist (doctor who specializes in respiratory problems) for medical interventions. Avoid using of over-the-counter drugs especially if there are other medications that are taken on regular basis – By Edterchelle Soriano