Protection Against Exercise-Induced Bronchoconstriction Two Hours After a Single Oral Dose of Montelukast

Philip, George; Villarán, César; Pearlman, David S.; Loeys, Tom; Dass, Sairia; Reiss, Theodore F.

doi:10.1080/02770900701209806

Cited by 46 publications

(32 citation statements)

References 24 publications

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“…It also improved postexercise recovery from EIB [40•]. A second similarly designed study of 62 patients with EIB showed similar effi cacy at 2 hours after a single dose of montelukast compared with placebo (11.7% for montelukast vs 17.5% for placebo; P ≤ 0.001) but failed to show a statistically signifi cant difference at 12 and 24 hours, in part because EIB severity waned in the placebo group at 12 and 24 hours after placebo administration [41]. A study of 19 children with EIB who were using an inhaled corticosteroid (ICS) demonstrated reduced EIB severity relative to placebo at 12 hours after the single dose but not 2 or 24 hours after the single dose [42].…”

Section: Acute Effects Of Leukotriene Modifi Ers On Eib Severitymentioning

confidence: 96%

Role of leukotrienes in exercise-induced bronchoconstriction

Hallstrand

Henderson²

2008

Curr Allergy Asthma Rep

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Exercise-induced bronchoconstriction (EIB) refers to acute airflow obstruction that is triggered by a period of physical exertion. EIB occurs mainly in individuals with other features of asthma but is especially prominent in a subset of asthmatics with pronounced indirect airway hyperresponsiveness. Leukotrienes (LTs) play a critical role in the pathophysiology of EIB. Asthmatics who are susceptible to EIB have increased levels of cysteinyl LTs (cysLTs [ie, LTs C4, D4, and E4]) in induced sputum and exhaled breath condensate. Exercise challenge in individuals susceptible to this disorder initiates the sustained increase in cysLTs in the airways and an increase in the ratio of cysLTs to prostaglandin E(2). The effects of cysLTs leading to secreted mucin release and smooth muscle constriction may be mediated in part through activation of sensory nerves. Therapies that block cysLT production or the cysLT(1) receptor effectively reduce the severity of EIB.

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Section: Acute Effects Of Leukotriene Modifi Ers On Eib Severitymentioning

confidence: 96%

Role of leukotrienes in exercise-induced bronchoconstriction

Hallstrand

Henderson²

2008

Curr Allergy Asthma Rep

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“…The most effective therapy for EIA is regular use of ICS [122]. Early use of leukotriene inhibition may be equally effective [149,150].…”

Section: Subgroups With Treatment Implicationsmentioning

confidence: 99%

Clinically relevant subgroups in COPD and asthma

Turner

Tamási

Schleich³

et al. 2015

Eur Respir Rev

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As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD) nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called "phenotypes"; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely.In this review, we describe subgroups of COPD and asthma patients whose clinical characteristics we believe have therapeutic or major prognostic implications specific to the lung, and whether these subgroups are constant over time. Finally, we will discuss whether the subgroups we describe are common to both asthma and COPD, and give some examples of how treatment might be tailored in patients where the subgroup is clear, but the label of asthma or COPD is not. @ERSpublications Summary of subgroups of airways disease that can be found in COPD and asthma, and their management

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“…Leukotriene modifiers such as montelukast are effective in treating EIB when given daily or 2 hours prior to exercise [41]. There has been no development of tolerance when leukotriene modifiers are given daily [42].…”

Section: Treatmentmentioning

confidence: 99%

Dyspneic athlete

Krey

Best

2014

Curr Rev Musculoskelet Med

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Breathing concerns in athletes are common and can be due to a wide variety of pathology. The most common etiologies are exercise-induced bronchoconstriction (EIB) and paradoxic vocal fold movement disorder (PVFMD). Although some patients may have both, PVFMD is often misdiagnosed as EIB, which can lead to unnecessary treatment. The history and physical exam are important to rule out life threatening pulmonary and cardiac causes as well as common conditions such as gastroesophageal reflux disease, sinusitis, and allergic etiologies. The history and physical exam have been shown to be not as vital in diagnosing EIB and PVFMD. Improvement in diagnostic testing with office base spirometry, bronchoprovocation testing, eucapnic voluntary hyperpnea (EVH) and video laryngoscopy are essential in properly diagnosing these conditions. Accurate diagnosis leads to proper management, which is essential to avoid unnecessary testing and save healthcare costs. Also important to the physician treating dyspnea in athletes is knowing regulations on medications, drug testing, and proper documentation needed for certain organizations. The differential diagnosis of dyspnea is broad and is not limited to EIB and PVFMD. Ruling out life threatening cardiac and pulmonary causes with a proper history, physical, and appropriate testing is essential. The purpose of this review is to highlight recent literature on the diagnosis and management of EIB and PVFMD as well as discuss other potential causes for dyspnea in the athlete.

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Protection Against Exercise-Induced Bronchoconstriction Two Hours After a Single Oral Dose of Montelukast

Cited by 46 publications

References 24 publications

Role of leukotrienes in exercise-induced bronchoconstriction

Role of leukotrienes in exercise-induced bronchoconstriction

Clinically relevant subgroups in COPD and asthma

Dyspneic athlete

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