Exercise-induced asthma is a common complex pulmonary disorder associated with a diagnosis of chronic asthma including cough, dyspnea, wheezing, and chest tightness that affects millions of patients worldwide. Exercise-induced asthma patients are frequently inhibited from participating in physical activities because of the degree of pulmonary dysfunction. Pharmacological agents, the cornerstone of treatment for exercise-induced asthma, improve pulmonary function and quality of life. Short-term and long-term adrenergic β2 sympathomimetics, mast cell stabilizers, leukotriene receptor antagonists, 5-lipoxygenase inhibitors, and corticosteroids are commonly used. β2 sympathomimetics are the most potent bronchodilators and are considered the first drug of choice. Inhaled corticosteroids and mast cell stabilizers assist with the reduction of airway inflammation and response to exercise and are generally added in combination with β2 sympathomimetics for maximum efficacy. Leukotriene receptor antagonists and inhibitors may be alternatives for patients who do not receive adequate prophylaxis with inhaled β2 sympathomimetics, corticosteroids, or mast cell stabilizers. Pharmacotherapeutic regimens must be tailored to meet the specific needs of patients. However, other factors must be considered, including side-effect profiles of the agents, cost, medication compliance, drug-drug and drug-disease interactions, insurance limitations, improvements in pulmonary function parameters, and understanding of the disease.
A comparison of tiotropium, long-acting β2-agonists and leukotriene receptor antagonists on lung function and exacerbations in paediatric patients with asthma