Treatment of the Asthmatic Athlete

Abstract

The early recognition and appropriate management of EIB can allow children and adolescents to participate fully in physical activities and sports. The diagnosis by history of chest congestion, coughing, and decreasing performance with exercise is helpful but is aided by a more systematic questionnaire that can detect otherwise healthy people with EIB. The diagnosis is finalized by performance of an exercise test such as a treadmill test or cycloergometer test to verify bronchospasm induced by exercise. The management can be accomplished by nonpharmacologic means such as participation in an early vigorous warm-up period, use of a face mask for rebreathing of warm air, or participation in a physical training program to increase anaerobic fitness. Medications for pharmacologic management include the use of cromolyn sodium, β-adrenergic agonists, theophylline, ipratromium bromide, and calcium channel blocking agents. In addition, the antihistamine terfenadine also can be used to effectively block exercise-induced bronchospasm in mild to moderate asthmatic patients. The medications can be used by those participating in both national and international competition when approved by the national governing body or the US Olympic Committee and the International Olympic Committe.