Question 2. How is exercise-induced asthma controlled?

From Chapter 8 of the Philippine Consensus Report on Asthma 2004 by the Philippine College of Chest Physicians.
This guideline starts below.

How is exercise-induced asthma controlled?

Answer

Exercise-induced asthma may be controlled through non-pharmacological or pharmacological means.

Summary of Evidence

Non-pharmacologic treatment entails avoiding inclement atmospheres and choosing a sport that is less likely to induce an asthmatic attack. A third strategy would be by inducing the known refractory period a few times earlier in the day of competition so that at the time of exercise competition, the neurohormonal transmitters are exhausted.

Pharmacological treatment methods can be divided into primary and secondary methods. The primary pharmacological agents given by inhalation are the beta-2-agonists, which will prevent exercise-induced bronchospasm in more than 80% of asthmatics. The most common are the rapid-acting, short-duration beta-2-agonists like salbutamol and terbutaline. The next most common are the rapid-onset, long duration formoterol and the slower-onset, long-duration beta-2-agonist salmeterol.

Secondary adjunctive treatment would be the use of agents for long-term control of asthma like inhaled corticosteroids, cromolyn, and anti-leukotrienes. The role of theophylline and anticholinergic agents are not clearly defined.