ABSTRACT
This chapter provides an overview of some of the issues faced when considering the pharmacological treatment of asthma +/– exercise induced bronchospasm (EIB) in athletes. An understanding of the best approach to the pharmacological treatment of asthma and EIB is vital to any clinician wishing to optimise respiratory care in athletes. Mast cell stabilisers, disodium cromoglycate and nedocromil sodium, attenuate both asthma and EIB when inhaled shortly before exercise. The only precaution should be to avoid physical exercise just after receiving the injection. Ipratropium bromide can also be used, pre-exercise, to prevent EIB, although the effect is not consistent among patients and may be variable, even within the same patient. In the general asthma population, it is well recognised that both inhaler technique and treatment adherence is suboptimal in the vast majority of patients. Patient adherence to prescribed treatment has been also shown to represent a crucial link between effective therapy and improved disease outcomes.
