Section 2. Exercise-induced bronchospasm albuterol versus montelukast Highlights of the asthma summit 2009 Beyond the guidelines 英文参考文献.docVIP

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Section 2. Exercise-induced bronchospasm albuterol versus montelukast Highlights of the asthma summit 2009 Beyond the guidelines 英文参考文献.doc

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Section 2. Exercise-induced bronchospasm albuterol versus montelukast Highlights of the asthma summit 2009 Beyond the guidelines 英文参考文献

CONFERENCEPROCEEDINGS Section2.Exercise-InducedBronchospasm:Albuterol versusMontelukast HighlightsoftheAsthmaSummit2009:BeyondtheGuidelines GeneColice,MD,FCCP,1 andWilliamJ.Calhoun,MD,FACP,FCCP,FAAAAI,FACAAI2 the bronchoconstriction with EIB in asthma patients ap- Abstract: Exercise-induced bronchospasm (EIB) involves airway pears to correlate with their degree of bronchial hyperre- 1 sponsiveness (BHR). EIBalsoappears inpatients whodo obstruction with an onset shortly after exercising. It can occur in individualswithoutadiagnosisofasthma,butismostcommonin asthmatic patients (and in this scenario may be referred to as exercise-inducedasthma,EIA),correlatingwiththepatient’sdegree of airway hyperreactivity. While albuterol is the most commonly used rescue and prophylactic medication for EIB, the leukotriene antagonist, monetlukast, may be an appropriate choice for some patients. Clinical data have shown that once-daily treatment with montelukast (5 or 10 mg tablet) can offer protection against EIB within 3 days for some patients. Such an approach might be preferredforpatientswhohavedif?cultywithinhaledmedications andforchildrenwhocannotaccesstheirinhalersduringtheschool day. Montelukast also may be an option to reduce side effects associatedwithalbuterolforindividualswhoexerciseregularly. not have asthma, but nonetheless exhibit BHR. In astudy of 281 nonasthmatic children, 10 (4%) experienced EIB and the EIB was signi?cantly associated with BHR to 2 histamine. However, neither asthma norBHRarerequired for the occurrence of EIB. In members of the 1998 US Winter Olympic team, EIB occurred in up to 50% of the athletes, with the speci?c proportion varying by sport. 3 Beforeconsideringwhichtreatmentsarepreferablefor EIB,onemustunderstandwhatEIBisnot.Itisnotshortness of breath during exercise in patients with asthma. Asthma patientswhogetshortofbreathwhileexercisingusuallyhave uncontrolled disease, not EIB. EIB should also not be con- sidered exercise-induced asthma (al