EXERCISEINDUCED ASTHMA

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EXERCISE-INDUCED ASTHMA

• William W. Storms
• Medicine and Science in Sport and Exercise
• 35(9)1464-1470, 2003

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ASTHMA AIRWAY HYPERREACTIVITY

• CAUSES
• Cold
• Pollen
• Mold
• Animal dander
• Infections
• Drugs

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EXERCISE-INDUCED ASTHMA

• Exercise-induced bronchospasm (EIB)
• bronchial obstruction (spasm) found after
  exercise in people with normal lung function at
  rest
• Exercise-induced asthma (EIA)
• exacerbation of a patients asthma when they
  exercise

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MECHANISMS

• Hyperosmolarity
• Water loss
• Hypertonicity
• Pro-inflammatory mediators
• Brochoconstriction

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MECHANISMS

• Airway Rewarming
• Cooling of airways during exercise
• Rewarming of airways during post-exercise
• Dilation of small bronchiolar
• Hyperemia of airway linings
• Release of bronchoconstrictors

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LIKELY CAUSES

• Continuous hard exercise, such as running
• Exercise in cold environments
• Exercise in polluted environments
• Exercise during pollen season
• Exercise during a respiratory infection

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UNLIKELY CAUSES

• Intermittent exercise or team games
• Swimming
• Exercise in warm, humid air
• Exercise in during non-pollen seasons
• Exercise in non-polluted air

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PREVALENCES
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SYMPTOMS
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DIAGNOSIS

• Symptoms
• History
• Physical exam
• FEV1 at least 90
• etc
• Follow-up

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DIAGNOSIS
Normal Obstruction
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TREATMENT

• Inform athlete of conditions likely, and not
  likely to trigger an EIA attack
• Warm-up at 80-90 of max
• Beta-agonist
• Albuterol, metaproterenol, pirbuterol, etc.
• Anticholinergics
• Ipratropium and tiotropium
• Side effects
• tremor, tachycardia, etc.
• Increased tolerance to mediation

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HERBAL SUPPLEMENTS

• Antioxidents
• Low salt
• Heparin

Comprehensive supplement to maintain healthy,
clean lung function. Traditional herbs, mullein
and slippery elm bark are in this formula also
containing Vitamin D, calcium and magnesium for
proper contraction of the smooth muscles of the
diaphragm and the intercostals which are
responsible for lung expansion and air intake for
bronchial and respirational support.
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DOPING

• Beta agonist
• Stimulant
• Steroid
• Allowed with proper medical documentation
• Written notification is no longer acceptable for
  Olympic athletes who wish to take inhaled beta2
  agonists for asthma. They must now submit
  clinical proof. When the diagnosis is
  questionable, the athletes will be required to
  take on-site airway function tests to assess
  their need for the medication.
• The new rule, adopted in June 2001 when the IOC
  and the World Anti-Doping Agency finalized the
  IOC antidoping code, took effect in September
  2001 in time for the 2002 Winter Olympic Games.
  PSM