Sports Medicine: Just the Facts

CHAPTER 36 • PULMONARY 213

MEDICATION CLASSES

ANTI-INFLAMMATORIES

• Inhaled glucocorticoids are the mainstay of treatment
  in moderate to severe asthma. Must be taken on a reg-
  ular basis, therefore not useful as a rescue medication.
  Side effects can include local irritation, dysphonia,
  and oral candidiasis. Systemic forms may be needed
  in asthma flares and cases recalcitrant to inhaled glu-
  cocorticoids.
  
  
  • Khellin derivatives, cromolyn sodium (Intal), and
    nedocromil sodium (Tilade) act to stabilize mast cells
    thus preventing the release of inflammatory media-
    tors. Both are inhaled medications and are for pre-
    ventive use. Cromolyn has no significant side effects,
    and is approved for children of age 5 and up. It may
    take 3 to 4 weeks for full clinical benefit (Smith and
    MacKnight, 1998). Nedocromil becomes effective in
    3 to 4 days, but can cause headache, cough, and bitter
    taste. It is approved in children over age 6.
  
  
  
  

TABLE 36-2 Stepwise Approach for Managing Asthma in Adults and Children Older Than 5 Years of Age: Treatment

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