Bronchial asthma of physical effort

In most patients with bronchial asthma and more than 40% of patients with allergic rhinitis, 10-15 minutes of physical activity causes bronchospasm, as indicated by a significant decrease in FEV1 . The more severe bronchial asthma, the more pronounced bronchospasm causes physical exertion. In some patients, asthma attacks develop only after physical exertion. The frequency and severity of asthma attacks caused by physical exertion depend on the nature of this exertion. Most often, bronchospasm occurs with fast running , less often with walking and cycling . Swimming usually does not cause bronchospasm. Bronchospasm usually develops 5-10 minutes after exercise and disappears at rest, less often it persists for more than 1 hour or worsens after exercise. Repeated loading in less than 2 hours is usually more easily tolerated than the previous one. The cause of bronchial asthma in physical effort appears to be cooling of the airways caused by hyperventilation. It has been shown that mediators of inflammation play a role in the pathogenesis of the disease , but the mechanism of the development of bronchospasm under the influence of cold air is still unknown. Treatment is mainly aimed at the prevention of seizures. The nature and duration of the load leading to bronchospasm is determined. Choose a load that is well tolerated by patients. It is recommended that periods of intense physical activity be short, between them the patient must rest. If improvement does not occur, bronchodilators are recommended before exercise . Beta-2 adrenostimulants are prescribed in the form of a dosed aerosol 15-20 minutes before the load. This is the most effective way to treat physical effort bronchial asthma. When prescribing drugs to athletes participating in competitions, it should be borne in mind that many organizational committees do not allow the use of catecholamines , for example, isoprenaline or isoetarin , while terbutaline and salbutamol – adrenostimulants that are not related to catecholamines – are allowed for use. In some cases, cromolyn is effective . It is used 15-60 minutes before exercise in the form of a metered aerosol (1600 μg) or powder for inhalation (20 mg). Before the use of cromolin, inhalation of adrenostimulants can be prescribed . Cromoline is used for intolerance to other drugs for the treatment of bronchial asthma of physical effort. Sometimes ipratropium bromide is effective , 1-2 breaths of a dosed aerosol 15-30 minutes before exercise. Patients who have difficulty using the inhaler, as well as in addition to inhaled drugs, are prescribed adrenostimulants or theophylline inside 1-2 hours before exercise. Parents of a sick child should report their illness to school teachers and trainers and explain that they must take bronchodilators before exercise, and in case of an attack needs rest.

event_note February 24, 2020

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