Evidence-based Pharmacy Practice (EBPP) : exercise-induced asthma

Abstract

Exercise-induced asthma (EIA) is a common condition that is frequently unrecognised, especially in school children and competitive athletes. Confirmation of EIA requires the use of an exercise test. Diagnosis cannot rely on self-reported symptoms alone. Cooling and drying of the airways play prominent roles in the mechanism of EIA. Inflammatory mediators also play a role. Both non-pharmacological and pharmacological approaches are often necessary to minimise the effects of EIA. Non-pharmacological approaches to treatment include warming up before exercise, nasal breathing, wearing a mask in cold environments, and avoidance of triggers. Dietary salt restriction and fish oil supplementation may also play a role in reducing the severity of EIA. Inhaled corticosteroids are the most effective drugs for managing asthma and preventing EIA. Short-acting β2 agonists are the most commonly used prophylactic agents for EIA. Long-acting β2 agonists and leukotriene receptor antagonists are also now used in the management of EIA. Pharmacists are well positioned to advise patients about proper medication use and proper inhaler technique. They can also educate patients about the non-pharmacological measures that can reduce or prevent EIA.