Montelukast sodium for exercise-induced asthma.
Exercise is the most common trigger of bronchospasm in children with asthma. Exercise-induced bronchoconstriction (EIB) occurs in up to 90% of individuals with asthma who are not under antiinflammatory treatment and in about 40% of those with allergic rhinitis. EIB may be an overwhelming problem in childhood and adolescence, when physical activity is a prominent component of daily life. The importance for those with asthma to maintain regular physical activity is recognized by asthma guidelines, which include the recommendation of full participation in sporting activities in their goals for the management of asthma. Cysteinyl leukotrienes, which are derivatives of the 5-lipoxygenase pathway of arachidonic acid metabolism, are important mediators of airway allergic inflammation and have a role in the pathogenetic mechanism of EIB. Montelukast sodium (Singulair, Merck & Co.) is a selective and orally active leukotriene receptor antagonist with demonstrated activity for treating asthma and allergic rhinitis. The effect of this drug in the prevention of EIB has been evaluated in a variety of studies in adults as well as in children. Both single-dose and regular-treatment studies showed that montelukast provides effective protection against EIB. Furthermore, chronic treatment with montelukast does not induce tolerance to the bronchoprotective effect over time. This aspect is particularly relevant for children, who tend to be active at frequent and irregular intervals throughout the day, and who therefore may benefit from around-the-clock pharmacologic protection.
de Benedictis
Fernando Maria
FM
Department of Pediatrics, Salesi Children's Hospital, Ancona, Italy. debenedictis@ao-salesi.marche.it
Vaccher
Silvia
S
de Benedictis
Diletta
D
D000085:Acetates / Q000494:pharmacology / Q000627:therapeutic use*; D000284:Administration, Oral; D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001250:Asthma, Exercise-Induced / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D003521:Cyclopropanes; D006801:Humans; D020024:Leukotriene Antagonists / Q000494:pharmacology / Q000627:therapeutic use*; D015201:Meta-Analysis as Topic; D015394:Molecular Structure; D011804:Quinolines / Q000494:pharmacology / Q000627:therapeutic use*; D013440:Sulfides
D000085:Acetates; D018927:Anti-Asthmatic Agents; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D011804:Quinolines; D013440:Sulfides; C093875:montelukast