Exercise-induced bronchospasm: implications for patients with or without asthma in primary care practice

Abstract

Exercise-induced bronchospasm (EIB) can represent a substantial barrier to physical activity. We present the cases of two patients with EIB, one with asthma, and one without asthma, who were evaluated at our primary care practice. The first case was a 44-year-old man with a history of seasonal allergic rhinitis but no asthma, who reported difficulty breathing when playing tennis. The second case was a 45-year-old woman who presented with persistent, generally well-controlled asthma, who was now experiencing bouts of coughing and wheezing during exercise. In both cases, an exercise challenge was used to diagnose EIB, and patients were prescribed a short-acting beta agonist to be used immediately before initiating exercise. EIB is a frequently encountered problem among patients presenting to primary care specialists. Affected patients should be made aware of the importance of proactive treatment with a short-acting beta agonist before initiating any exercise.

Keywords:

• asthma
• compliance
• exercise-induced bronchospasm

Acknowledgments

The EIB Landmark Survey was conducted by the national public opinion research organization Abt SRBI Inc, in partnership with Strategic Pharma Solutions, LLC, and was sponsored by Teva Respiratory, LLC. The authors wish to acknowledge the technical and editorial support provided by ApotheCom.

Disclosure

Dr Stoloff: Teva (grant/research support, consultant). Dr Colice: Teva (consultant, speakers’ bureau), Boehringer Ingelheim (consultant, speakers’ bureau), Pfizer (consultant, speakers’ bureau), GlaxoSmithKline (consultant, speakers’ bureau), Merck (consultant, speakers’ bureau), Vatera (consultant, speakers’ bureau), MedImmune (consultant, speakers’ bureau). Ms Hayden: Teva (consultant), Dey Laboratory, Sunovian, Merck (speakers’ bureau). Dr Craig: Teva (speakers’ bureau). Dr Ostrom: Alcon (grant/research support), Amgen (grant/research support), Apotex (grant/research support), AstraZeneca (grant/research support, consultant, speakers’ bureau), Boehringer Ingelheim (grant/research support), CRN (consultant), GlaxoSmithKline (grant/research support, speakers’ bureau), HRA (grant/research support), ISTA (consultant), MedImmune (grant/research support), Novartis (grant/research support), Proctor & Gamble (grant/research support), Schering-Plough (grant/research support), Sunovion (Sepracor) (grant/research support), Teva (grant/research support, consultant, speakers’ bureau). Dr Eid: Teva (consultant, speakers’ bureau). Dr Parsons: Teva (consultant).