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 WHAT IS IT NECESSARY TO AVOID AND WHAT MUST NOT BE DONE
- To avoid to realize an intense physical activity when the asthma of every day is not controlled, if a respiratory infection is had, if whistles are evident or many cough is had.
- When the meter of maximum flow is used, to never do exercise if flows register abnormally low.
- To avoid whenever it is possible the cold and dry ambiences. If it was necessary to do exercise in these conditions, to use a mask surgical type, to be able to be with filter valvular (mask type 3M). In certain sports, the effect mask can be obtained by means of a helmet.
- To avoid the exercise in contaminated ambiences or with smoke.
- To avoid to do very intense exercises or of many duration, especially while a good physical condition has not been reached and the personal limits of the exercise are not known.
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HANDLING OF A CRISIS DURING THE EXERCISE
- To calm the child. If the panic accompanies to the shortness of breath, there will be added a situation of excessive hyperventilation, which can take a precocious respiratory alcalosis, with parestesias symptoms and even tetania (muscular spasms).
- To stop doing the exercise, or slowing down it up to the tolerated minimum.
- To allow that to be able to be breathed well. The partners must not be located about the person who has the attack.
- To take the medicines broncodilatadoras - in general ß-mimetic medicines "of rescue" or rapid action - as soon as possible.
- To initiate the sibilant respiration. To gather the lips as if it was going to whistle. This type of respiration allows the air to be able to go out of the lungs and avoids the rapid, superficial and ineffective respiration of the hyperventilation.
- When the crisis is solved, to try to return again to the class to finish it if one is not very tired, but to do the exercise of a softer way. If the child does not recover as in other occasions, it is necessary to take another bronchodilator dose and to consult a doctor or to come to a sanitary center.
PHARMACOLOGICAL HANDLING OF THE AIE
The AIE can be an only one factor that indicates bad handling of severe or unstable fund of a bronchial asthma. In these cases, the correct maintenance treatment (inhaled steroids, etc) contributes that the AIE weakens or recovers. But when the AIE happens in spite of everything, or presents itself as an isolated fact, the following medicines are used:
- Beta-2 adrenérgicos. There are the most effective medicines in the prevention of the AIE. The inhaled route is that of election, and the only one allowed in sport of competition. Those of short action-salbutamol (Ventolin ®), terbutalina (Terbasmin ®)-is inhaled from 15 until 30 minutes before the exercise and has an action duration from 4 until 6 hours. Those of action prolonged like the salmeterol (Beglan ®, Serevent ®, Inaspir ®, Betamican ®) or the formoterol (Oxis ®, Neblik ®, Foradil ®) inhales between 30 minutes and 1 hour earlier, and his action duration is initially of approximately 9 at 12 hours, although it tends to diminish with the time. ß-adrenérgicos oral (Ventolin ®, Terbasmin ®, Respiroma ®, Ventolase ®, Bambec ®, etc) is used like alternative when the inhaled route is not possible; they have more frequent adverse effects and the required doses are higher; they are not allowed in competitions.
Cromonas. The cromoglicato (Unsuch ®) it inhibits the mastocitos degranulación and is capable of preparing the AIE in 60-70 % of the patients. The nedocromil sódico (Ildor ®, Brionil ®, Cetimil ®, Tilad ®) has similar effects. They have the added advantage sobtre the ß-mimetic ones of preparing the late asthmatic reaction. Anticolinérgicos. (Atrovent ®) To dose of 80 µg, it is capable of inhibiting the AIE himself in some patients. Associate is used also to fenoterol (Combivent ®). Inhibiting of leucotrienos. Montelukast (Singulair ®) and zafirlukast (Accolate ®) is new anti-inflammatory specially directed against the synthesis or the action of the leucotrienos (mediators lípidos broncoconstrictores and proinflamatorios) in the bronchial tree. In preliminary studies, montelukast it has demonstrated to inhibit the AIE in 3 of every 4 patients during periods of up to 20 hours, although perhaps it is still prompt to define the role of these medicines in the arsenal of medicines to be used in the AIE. At the moment, they are not allowed in the competition sport.
The athletes and sportsmen of competition must know that any medication that they take must declare itself, and be always allowed by the regulations of the International Olympic Committee.
MEDICATIONS FOR THE SPORTSMAN WITH ASTHMA (ALLOWED BY THE C.O.I).
(BOE 2/25/1997)
Clinical record must be enclosed with precedents, the clinical state and treatment current and results of the test of broncoconstricción of the effort.
Beta2 agonistas allowed: Only they are allowed in the shape of inhalation in aerosol, and there is needed a written notification directed to the medical commission of the C.O.I. or the pertinent federative organism on his use. They are allowed:
- Terbutalina (Terbasmin ®)
- Salbutamol (Ventolin ®, Butoasma ®),
- Salmeterol (Beglan ®, Serevent ®, Inaspir ®, Betamican ®)
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Fenoterol, Procaterol, Formoterol |
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ß-agonistas oral or parenterales. |
Corticoids: In the shape of aerosol, or nasal inhaler, and always with a written notification of the doctor who prescribes it to the same organisms.
They are not allowed: Systemic corticoids.
Other authorized antiasthmatic medications: They do not need notification, although also it is advised:
- Nedocromil sódico
- Cromoglicato disódico *
- Bromide of Ipratropio *
- Aminofilina and teofilina (To therapeutic doses)
- Antihistamínicos*
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Inhibiting of leucotrienos |
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"Descongestivos" adrenérgicos (ephedrine, pseudoephedrine...) |
He advises himself not to use those who are "composed" since they can take substances (fenoterol or ß-mimetic others not allowed, pseudoephedrine, etc), which are considered to be a positive doping or to do that the concentration of other (aminofilinas) reaches the positividad levels.
TO KNOW MORE
WHAT DOCTOR CAN TREAT ME?
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TO AVOID 
